Bio-absorbable antibiotic impregnated beads for the treatment of prosthetic vascular graft infections

被引:20
作者
Genovese, Elizabeth A. [1 ]
Avgerinos, Efthymios D. [1 ]
Baril, Donald T. [1 ]
Makaroun, Michel S. [1 ]
Chaer, Rabih A. [1 ]
机构
[1] Univ Pittsburgh, Med Ctr, Div Vasc Surg, Inst Heart & Vasc, 200 Lothrop St PUH A-1017, Pittsburgh, PA 15213 USA
关键词
Prosthesis-related infections; anti-bacterial agents; drug implants; CALCIUM-SULFATE; OSTEOMYELITIS; EXPERIENCE; PMMA; MANAGEMENT; DELIVERY; SALVAGE;
D O I
10.1177/1708538116630859
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective: There is limited investigation into the use of bio-absorbable antibiotic beads for the treatment of prosthetic vascular graft infections. Our goal was to investigate the rates of infection eradication, graft preservation, and limb salvage in patients who are not candidates for graft explant or extensive reconstruction. Methods: A retrospective review of patients implanted with antibiotic impregnated bio-absorbable calcium sulfate beads at a major university center was conducted. Results: Six patients with prosthetic graft infections were treated with bio-absorbable antibiotics beads from 2012-2014. Grafts included an aortobifemoral, an aorto-hepatic/superior mesenteric artery, and four extra-anatomic bypasses. Pathogens included Gram-positive and Gram-negative bacteria. Half of the patients underwent graft explant with reconstruction and half debridement of the original graft, all with antibiotic bead placement around the graft. Mean follow-up was 7.3 +/- 8.3 months; all patients had infection resolution, healed wounds, and 100% graft patency, limb salvage, and survival. Conclusion: This report details the successful use of bio-absorbable antibiotic beads for the treatment prosthetic vascular graft infections in patients at high risk for graft explant or major vascular reconstruction. At early follow-up, we demonstrate successful infection suppression, graft preservation, and limb salvage with the use of these beads in a subset of vascular patients.
引用
收藏
页码:590 / 597
页数:8
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