| Treatment of Vascular
Graft Infection after Operation for Thoracic Aortic Aneurysms |
(Division of Thoracic and Cardiovascular Surgery,
Department of Surgery, Kawasaki Medical School, Kurashiki, Japan)
| Hiroshi Inada |
Taiji Murakami |
Hisao Masaki |
| Ichiro Morita |
Atsushi Tabuchi |
Atsuhisa Ishida |
| Koichi Endo |
Daiki Kikukawa |
Takashi Fujiwara |
|
During 23 years, 224 cases underwent
graft replacement of thoracic aortic aneurysms at our institution.
Of these, 14 cases suffered postoperative vascular graft infection.
Out of the 14 cases, 13 cases had sternal or mediastinal infections,
and one case showed sepsis without these deep wound infections.
Six cases were positive by blood culture. We thought that sternal
or mediastinal infections had a high possibility of contamination
of vascular grafts and that cases with these deep wound infections
should be treated as cases of graft infection. Reoperation was
done urgently soon after the diagnosis of infection was made.
When the wound was not so deep, only debridement was performed.
In addition to debridement, continuous irrigation through a chest
tube and, recently, pedicled omental flap placement were done,
when the wound was deep. Except for the one case without deep
wound infection, 13 cases were reoperated. There were 4 hospital
deaths; 3 operated cases and the nonoperated case, due to lack
of control of their infection. Blood culture were positive in
all these four cases. The other 10 cases were discharged from
hospital without infection. Infection of vascular grafts after
operation for thoracic aortic aneurysms is a serious complication
and urgent reoperation should be done. However it should be noted
that the mortality rate of cases with positive blood culture
is high.
Jpn. J. Cardiovasc. Surg. 29: 10-16 (2000) |
|
