Use of a Silver-Impregnated Vascular Graft: Single-Center Experience
Introduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Antibiotics |
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| Online Access: | https://www.mdpi.com/2079-6382/11/3/386 |
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| author | Jiri Molacek Vladislav Treska Karel Houdek Václav Opatrný Bohuslav Certik Jan Baxa |
| author_facet | Jiri Molacek Vladislav Treska Karel Houdek Václav Opatrný Bohuslav Certik Jan Baxa |
| author_sort | Jiri Molacek |
| collection | DOAJ |
| description | Introduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have a vascular graft that is resistant to infection. In this retrospective clinical study, a silver-impregnated vascular graft was evaluated in various indications. Methods: Our study included a total of 71 patients who received a silver-impregnated vascular graft during the period from 2013 to 2018. Patients had an aortoiliac localization of vascular graft in 61 cases (86%), and a peripheral localization on the lower limbs in 10 cases (14%). Indications for the use of these special vascular grafts were trophic lesions or gangrene in the lower limbs in 24 cases (34%), suspicious mycotic abdominal aortic aneurysm (mAAA) in 4 cases (5.5%), salmonela aortitis or aneurysms in 4 cases (5.5%), infection of the previous vascular graft in 11 cases (15.5%), other infections in 12 cases (17%), AAA rupture in 10 cases (14%) and other reasons (pre-transplant condition, multiple trauma, graft-enteric fistula) in 6 cases (8.5%). Thirty-day mortality, morbidity, the need for reintervention and amputation, primary and secondary graft patency, and finally the presence of a proven vascular graft infection were evaluated. Results: The 30-day mortality was 19.7%, and morbidity was 42.2%. The primary patency of the vascular graft was 91.5%. Reoperation was necessary in 10 cases (14%) and amputation was necessary in 10 cases (14%). The median length of hospital stay was 13 days and the mean follow-up period was 48 ± 9 months. During the follow-up period, six patients (8.5%) died from reasons unrelated to surgery or without any relation to the vascular graft. Secondary patency after one year was 88%. Infection of the silver graft was observed in three patients (4.2%). Conclusions: Based on our results, the silver graft is a very suitable alternative for solving infectious, or potentially infectious, situations in vascular surgery. In particular, in urgent or acute cases, a silver graft is often the only option. |
| first_indexed | 2024-03-09T20:11:17Z |
| format | Article |
| id | doaj.art-0c5a1c5d2e184140be82be16a907f741 |
| institution | Directory Open Access Journal |
| issn | 2079-6382 |
| language | English |
| last_indexed | 2024-03-09T20:11:17Z |
| publishDate | 2022-03-01 |
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| record_format | Article |
| series | Antibiotics |
| spelling | doaj.art-0c5a1c5d2e184140be82be16a907f7412023-11-24T00:11:47ZengMDPI AGAntibiotics2079-63822022-03-0111338610.3390/antibiotics11030386Use of a Silver-Impregnated Vascular Graft: Single-Center ExperienceJiri Molacek0Vladislav Treska1Karel Houdek2Václav Opatrný3Bohuslav Certik4Jan Baxa5Vascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicVascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicVascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicVascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicVascular Surgery Department, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicDepartment of Imagine Methods, University Hospital in Pilsen, Faculty of Medicine in Pilsen, Charles University, Husova 3, 301 00 Plzeň, Czech RepublicIntroduction: Vascular graft infection is a life threatening situation with significant morbidity and mortality. Bacterial graft infection can lead to false aneurysms, bleeding and sepsis. There are a lot of risky situations where grafts can become infected. It is therefore highly desirable to have a vascular graft that is resistant to infection. In this retrospective clinical study, a silver-impregnated vascular graft was evaluated in various indications. Methods: Our study included a total of 71 patients who received a silver-impregnated vascular graft during the period from 2013 to 2018. Patients had an aortoiliac localization of vascular graft in 61 cases (86%), and a peripheral localization on the lower limbs in 10 cases (14%). Indications for the use of these special vascular grafts were trophic lesions or gangrene in the lower limbs in 24 cases (34%), suspicious mycotic abdominal aortic aneurysm (mAAA) in 4 cases (5.5%), salmonela aortitis or aneurysms in 4 cases (5.5%), infection of the previous vascular graft in 11 cases (15.5%), other infections in 12 cases (17%), AAA rupture in 10 cases (14%) and other reasons (pre-transplant condition, multiple trauma, graft-enteric fistula) in 6 cases (8.5%). Thirty-day mortality, morbidity, the need for reintervention and amputation, primary and secondary graft patency, and finally the presence of a proven vascular graft infection were evaluated. Results: The 30-day mortality was 19.7%, and morbidity was 42.2%. The primary patency of the vascular graft was 91.5%. Reoperation was necessary in 10 cases (14%) and amputation was necessary in 10 cases (14%). The median length of hospital stay was 13 days and the mean follow-up period was 48 ± 9 months. During the follow-up period, six patients (8.5%) died from reasons unrelated to surgery or without any relation to the vascular graft. Secondary patency after one year was 88%. Infection of the silver graft was observed in three patients (4.2%). Conclusions: Based on our results, the silver graft is a very suitable alternative for solving infectious, or potentially infectious, situations in vascular surgery. In particular, in urgent or acute cases, a silver graft is often the only option.https://www.mdpi.com/2079-6382/11/3/386antibioticsgraft patencysilver-impregnated vascular graftvascular graft infection |
| spellingShingle | Jiri Molacek Vladislav Treska Karel Houdek Václav Opatrný Bohuslav Certik Jan Baxa Use of a Silver-Impregnated Vascular Graft: Single-Center Experience Antibiotics antibiotics graft patency silver-impregnated vascular graft vascular graft infection |
| title | Use of a Silver-Impregnated Vascular Graft: Single-Center Experience |
| title_full | Use of a Silver-Impregnated Vascular Graft: Single-Center Experience |
| title_fullStr | Use of a Silver-Impregnated Vascular Graft: Single-Center Experience |
| title_full_unstemmed | Use of a Silver-Impregnated Vascular Graft: Single-Center Experience |
| title_short | Use of a Silver-Impregnated Vascular Graft: Single-Center Experience |
| title_sort | use of a silver impregnated vascular graft single center experience |
| topic | antibiotics graft patency silver-impregnated vascular graft vascular graft infection |
| url | https://www.mdpi.com/2079-6382/11/3/386 |
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