O'Brien T, Collin J
Nuffield Department of Surgery, John Radcliffe Hospital, Oxford, UK.
Br J Surg. 1992 Dec;79(12):1262-7. doi: 10.1002/bjs.1800791205.
The aetiology, diagnosis and management of prosthetic vascular graft infection are reviewed. The importance of contamination at the time of surgery as the crucial aetiological factor is highlighted. Staphylococcus epidermidis is the causative organism in over 50 per cent of cases and the reasons for this are explored. Sound surgical technique, use of prophylactic antibiotics and the avoidance of a groin incision are emphasized as the most important factors in prevention of graft infection. Difficulties of diagnosis are highlighted and the diagnostic role of various imaging methods is assessed. Graft excision with extra-anatomic revascularization is presented as the conventional surgical solution, while the roles of less radical surgical solutions and non-operative management are discussed.
本文综述了人工血管移植感染的病因、诊断及处理。强调了手术时污染作为关键病因的重要性。表皮葡萄球菌是超过50%病例的致病微生物，并探讨了其原因。强调合理的手术技术、预防性抗生素的使用及避免腹股沟切口是预防移植感染的最重要因素。突出了诊断的难点，并评估了各种影像学方法的诊断作用。介绍了采用解剖外血管重建的移植物切除术作为传统的手术解决方案，同时讨论了不太激进的手术解决方案及非手术治疗的作用。
