Infections and antibiotic prophylaxis in reconstructive vascular surgery

Research output: Contribution to journalArticle

Abstract

In 98 patients undergoing elective vascular surgery, specimens for bacterial cultures were obtained from urine, ischaemic ulcers, incisional wounds and the implanted grafts. Wound and graft infections were registered and compared with the results of these cultures and suspected risk factors in an attempt to find the source of infections. Antibiotic prophylaxis with cefuroxime was given for 24 h beginning at the start of surgery. Patients with ischaemic ulcers also received "spread prophylaxis", directed against isolated bacteria, for ten days. Three cases of graft infection and twelve cases of wound infection occurred. Positive postoperative cultures from wounds did not correlate with pre- or peroperative cultures. Peroperative cultures revealed small numbers of staphylococcus epidermidis in eleven patients, and none of them developed graft infection. Ischaemic ulcers, diabetes or re-do procedures were not accompanied by a significantly increased frequency of wound or graft infection, although each of three patients with graft infection had one of these risk factors. Bacteria, sensitive to cefuroxime, were found in one graft infection, six wound infections, and in two patients with urosepsis, whereas cefuroxime resistant organisms were isolated from one graft infection and three infected wounds. One of the three graft infections was probably caused by bacteria originating from the patient's ischaemic ulcer. In the other two patients the source of bacteria could not be determined. Cefuroxime seems to be an adequate alternative for prophylaxis of vascular graft infection, but in some patients with bacteriuria or indwelling catheters, a one day regimen may be too short.

Details

Authors
  • Andreas Herbst
  • Carl Kamme
  • Lars Norgren
  • Peter Qvarfordt
  • Else Ribbe
  • Johan Thörne
Organisations
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Obstetrics, Gynecology and Reproductive Medicine
  • Clinical Medicine
  • Surgery

Keywords

  • Vascular Surgery, Infection, Grafts, Cefuroxime
Original languageEnglish
Pages (from-to)303-307
JournalEuropean Journal of Vascular Surgery
Volume3
Issue number4
Publication statusPublished - 1989
Publication categoryResearch
Peer-reviewedYes

Bibliographic note

The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Surgery (Lund) (013009000), Department of Obstetrics and Gynaecology (Lund) (013018000), Emergency medicine/Medicine/Surgery (013240200)