Obturator foramen bypass in the management of infected vascular prostheses.

Seven patients with infected vascular prostheses in the femoral region were treated by removal of the prosthesis and extraanatomic reconstruction by way of the obturator foramen. Because the operation avoided entry into the infected area, it was considered the best surgical treatment for these patients. Although catastrophic hemorrhage and systemic sepsis were averted, amputation was eventually necessary in five patients, usually because of severe arteriosclerotic disease in distal arteries. Short-term benefit was gained by only two patients. The prevention of infection demands intensive preoperative preparation using prophylactic antibiotics and meticulous operating room technic.