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血管缝线感染:26例报告(作者译)

[Infection of vascular sutures: a report on 26 cases (author's transl)].

作者信息

Leturgie C, Chamoun S, Watelet J, Teniere P, Testart J

出版信息

J Chir (Paris). 1980 Apr;117(4):219-30.

PMID:6448864
Abstract

The authors describe 26 cases of infection after vascular surgery, affecting a Dacron prosthesis in 13 cases and venous grafts in the other 13 patients. The site of infection was usually the region of Scarpa's triangle (15 cases) with the presence of enterobacterium in 40% of cases. The most frequently isolated germ was staphylococcus aureus (20 cases). Infection was revealed by hemorrhage in 17 patients and was evidence of breaking down of the anastomosis. Results of surgical treatment in the two groups were evaluated by using three criteria: --persistence or not of infection, --vital prognosis, --functional prognosis. Surgical treatment methods and possible contamination sources are discussed. When the operative zone is infected, the authors recommend ablation for the prostheses and conservative therapy for venous autografts. The prosthesis was left in place in 5 patients, and only one patient recovered, while two deaths occurred. In the 10 cases where ablation of the prosthesis was performed, however, the infection was cured, and in 4 patients there was revascularization in the infected area. Apart from these cases, conservative therapy was applied in 11 cases and healing occurred in all of them.

摘要

作者描述了26例血管手术后感染病例,其中13例影响涤纶人工血管,另外13例影响静脉移植物。感染部位通常在斯卡帕三角区(15例),40%的病例存在肠道细菌。最常分离出的病菌是金黄色葡萄球菌(20例)。17例患者因出血而发现感染,这是吻合口破裂的证据。通过三个标准评估两组患者的手术治疗结果:——感染是否持续,——生命预后,——功能预后。讨论了手术治疗方法和可能的污染源。当手术区域被感染时,作者建议切除人工血管并对自体静脉移植物进行保守治疗。5例患者保留了人工血管,仅1例康复,2例死亡。然而,在进行人工血管切除的10例病例中,感染得到治愈,4例患者感染区域实现了血管再通。除这些病例外,11例采用了保守治疗,所有患者均治愈。

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