title: Treatment of surgical site infections (SSI) IN patients with peripheral arterial disease: an observational study.
abstract: BACKGROUND
  The management of surgical site infections (SSI's) in vascular surgery has been challenging over the years. To assess the outcomes associated with the various strategies, we performed a review of all SSI's after elective vascular procedures in patients with moderate to severe peripheral arterial disease in a single centre hospital.
  
  
  METHODS
  All patients with a SSI after peripheral vascular surgery were retrieved from a database on Surgical site infections (SSI)-surveillance after vascular surgery between March 2009 and January 2012. At admission, all patients were approached by microbiological wound sampling and empirical start of antibiotics. Further wound management was based on personal experience and preference of the attending vascular surgeon. Endpoints were treatment success (complete wound healing while staying alive and without major amputation), survival and major amputation during one year follow up.
  
  
  RESULTS
  A total of 40 patients with a SSI were identified (60% superficial SSI and 40% deep SSI). In 92% of the patients with a superficial SSI's were successfully treated with adjusted antibiotics and incisional drainages. In the contrast, 25% of the patients with deep-SSI's were successfully treated. No particular treatment was more successful than the others.
  
  
  CONCLUSIONS
  Adjusted antibiotic use and adequate wound drainage are sufficient strategies for superficial SSI management. The management of deep-SSI's is a challenging undertaking and future research on indications and timing of these wide arrays of treatment options is suggested.
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands. Electronic address: JvanderSlegt@amphia.nl.
authors.forename: Jasper
authors.initials: J
authors.lastname: van der Slegt
authors.affiliation: Laboratory for Microbiology and Infection Control, Amphia Hospital, Breda, The Netherlands; Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: Jan A J W
authors.initials: JA
authors.lastname: Kluytmans
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Hans G W
authors.initials: HG
authors.lastname: de Groot
authors.affiliation: Department of Surgery, Amphia Hospital, Breda, The Netherlands.
authors.forename: Lijckle
authors.initials: L
authors.lastname: van der Laan
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000601:surgery*; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000628:therapy*; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014945:Wound Healing / Q000502:physiology
keywords: Surgical site infection; Treatment; Vascular surgery