de Camargo Paula Angeleli Bueno, Bertanha Matheus, Moura Regina, Jaldin Rodrigo Gibin, Yoshida Ricardo de Alvarenga, Pimenta Rafael Elias Farres, Mariúba Jamil Victor de Oliveira, Sobreira Marcone Lima
Universidade Estadual Paulista "Júlio de Mesquita Filho" - UNESP, Faculdade de Medicina de Botucatu, Departamento de Cirurgia e Ortopedia, São Paulo, SP, Brasil.
J Vasc Bras. 2016 Oct-Dec;15(4):312-316. doi: 10.1590/1677-5449.002816.
Infections at the sites of surgery involving synthetic prostheses are challenging to treat. We present a case of a patient with multiple comorbidities who had undergone an aortobifemoral bypass 6 years previously and then re-intervention at the femoral anastomoses for restenosis 5 years previously. The patient presented with acute left inguinal pain and swelling and was diagnosed with a ruptured femoral pseudoaneurysm and hemodynamic instability. A repair was conducted by interposition of a silver-coated Dacron graft in the emergency room, and a large abdominal incisional hernia was repaired with synthetic mesh during the same intervention. After surgery, the patient remained intubated in intensive care for a long period. Meanwhile, she presented dehiscence of sutures and a left inguinal purulent fistula that was in contact with the vascular prosthesis. Conservative treatment was chosen, with debridement of wounds and vacuum therapy. The patient improved and the wounds healed. This could be an important tool in similar cases.
涉及人工合成假体的手术部位感染治疗颇具挑战性。我们报告一例患有多种合并症的患者，该患者6年前接受了主动脉双股动脉搭桥手术，5年前因再狭窄在股动脉吻合处进行了再次干预。患者出现急性左腹股沟疼痛和肿胀，被诊断为股动脉假性动脉瘤破裂和血流动力学不稳定。在急诊室通过置入镀银涤纶移植物进行了修复，并在同一手术过程中用合成补片修复了一个大的腹部切口疝。术后，患者在重症监护室长期插管。与此同时，她出现了缝线裂开和与血管假体接触的左腹股沟脓性瘘管。选择了保守治疗，包括伤口清创和负压治疗。患者病情好转，伤口愈合。这在类似病例中可能是一个重要手段。
