Folsom D L, Franceschi D, Rubin J R
School of Medicine, Case Western Reserve University, Cleveland, Ohio.
J Cardiovasc Surg (Torino). 1992 Nov-Dec;33(6):660-3.
The lymphatic system has been implicated as a source of synthetic graft contamination when grafts are implanted in the presence of a distal septic focus. In previous studies, radical lymphatic excision and ligation were shown to reduce acute graft sepsis. However significant lymphedema precluded its clinical application. The present study was undertaken to evaluate methods for reducing acute graft sepsis while avoiding lymphatic obstructive complications. Twenty dogs were divided into one control and two experimental cohorts. Femoral interposition grafts were placed in each dog. A hind paw septic focus was introduced and therapy included a control (Group I--no therapy), intravenous antibiotics in Group II and intralymphatic antibiotics in Group III. Graft, blood and tissue cultures from each dog were taken at 48 hours. Lymphatic antibiotic therapy resulted in significantly improved graft culture results when compared to the control (p = 0.0003) and intravenously treated animals (p = 0.007). Blood cultures in the intralymphatically treated group were also significantly better (p = 0.003) than the control group.
当移植物在存在远端感染灶的情况下植入时，淋巴系统被认为是合成移植物污染的一个来源。在先前的研究中，根治性淋巴切除和结扎被证明可减少急性移植物败血症。然而，严重的淋巴水肿使其无法在临床上应用。本研究旨在评估在避免淋巴阻塞并发症的同时减少急性移植物败血症的方法。20只狗被分为一个对照组和两个实验组。在每只狗身上植入股动脉间置移植物。引入后爪感染灶，治疗方法包括对照组（第一组——不治疗）、第二组静脉注射抗生素和第三组淋巴管内注射抗生素。在48小时时采集每只狗的移植物、血液和组织培养样本。与对照组（p = 0.0003）和静脉治疗的动物（p = 0.007）相比，淋巴管内抗生素治疗使移植物培养结果显著改善。淋巴管内治疗组的血液培养结果也明显优于对照组（p = 0.003）。
