Treatment of a rare case of local prosthetic graft infection with silver coated prosthesis.

The infection after synthetic vascular prosthetic graft implantation remains a serious complication of reconstructive vascular surgery. Surgical treatment consists of complete removal of the infected vascular graft with the preservation of the limb circulation. In this paper the case of aortofemoral by-pass infection limited to the distal part of the branches is presented. Because of the unsatisfactory results of conventional treatment the patients underwent the in situ replacement of infected prosthesis with the silver/collagen coated prosthesis. The postoperative check up (clinical examination, duplex-doppler ultrasound, scintigraphy of Technetium 99m-labeled leucocytes) revealed the complete remission of infection. The surgery can be limited to the replacement of infected segment of prosthesis with arterial homograft, but this therapeutic method requires further investigations and scrupulous observations.