Less Than Total Excision of Infected Prosthetic PTFE Graft Does Not Increase the Risk of Reinfection.
BACKGROUND
Traditional treatment of infected polytetrafluoroethylene (PTFE) grafts consist of removal of the entire prosthesis. Closure of the native vessels may compromise vascular patency. We examined the outcomes for patients in whom a PTFE remnant of an infected graft was retained on the vessel.


METHODS
We reviewed the operating room log from 2000 to 2011 and identified all patients who had partial removal of an infected PTFE graft used for hemodialysis or peripheral bypass. These patients were examined for subsequent complications.


RESULTS
Twenty-seven patients underwent 30 partial graft excisions with mean follow-up of 27 months. A total of 17% (5 of 30) of the partial graft resection procedures resulted in complications. Of 48 total remnants left behind at the arterial or venous anastomoses, reinfection occurred in 15%.


CONCLUSIONS
Leaving a well-incorporated small 1-to 5-mm PTFE remnant at the arterial or venous anastomoses can be performed safely with a low risk of complications.
Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA sgroim@uci.edu.
Michael D
MD
Sgroi
Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA.
Vincent E
VE
Kirkpatrick
Department of Surgery, University of California, Irvine Medical Center, Orange, CA, USA.
Karen A
KA
Resnick
Department of Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA.
Russell A
RA
Williams
Department of Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA.
Samuel E
SE
Wilson
Department of Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA.
Ian L
IL
Gordon
D000368:Aged; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects* / Q000295:instrumentation*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D020878:Device Removal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000601:surgery; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D016459:Prosthesis-Related Infections / Q000175:diagnosis / Q000382:microbiology / Q000601:surgery*; D012008:Recurrence; D006435:Renal Dialysis; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D011138:Polytetrafluoroethylene
infected grafts; reinfection; retained PTFE