Ghosn P B, Rabbat A G, Trudel J
Can J Surg. 1983 Jul;26(4):330-1.
The radical treatment of infected vascular grafts is a major procedure with a high mortality and loss of limb. The authors review their experience with 13 consecutive cases of infected aortofemoral grafts treated conservatively during an 11-year period. The treatment consisted of wide incision and drainage of the infected area followed by assiduous irrigation with an antiseptic or antibiotic solution. In 10 patients the inguinal wound healed and the prosthesis was reincorporated; 8 of the 10 had a patent prosthesis and the treatment was considered successful, while 2 needed further surgery. Three patients died of hemorrhage or sepsis. Follow-up ranged from 8 to 144 months (mean 77 months). Two patients had a false aneurysm 3 and 7 years after wound healing. The results compare favourably with those of radical treatment. The authors believe a conservative approach must always be tried as the first step in the management of infected vascular prostheses. The gratifying results observed in their series, in both the short and long term, support this conservative approach, which is a satisfying alternative to radical operations with their high mortality and morbidity.
感染性血管移植物的根治性治疗是一项大手术，死亡率高且有肢体丧失风险。作者回顾了他们在11年期间对13例连续性感染性主-股动脉移植物进行保守治疗的经验。治疗方法包括对感染区域进行广泛切开引流，随后用抗菌或抗生素溶液进行持续冲洗。10例患者腹股沟伤口愈合，假体重新纳入体内；其中8例假体通畅，治疗被认为成功，而2例需要进一步手术。3例患者死于出血或败血症。随访时间为8至144个月（平均77个月）。2例患者在伤口愈合后3年和7年出现假性动脉瘤。结果与根治性治疗相比更有利。作者认为，对于感染性血管假体的处理，必须始终首先尝试保守方法。他们系列中观察到的短期和长期的令人满意的结果支持了这种保守方法，这是一种令人满意的替代方法，可替代具有高死亡率和发病率的根治性手术。
