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Outcome after VAC(®) Therapy for Infected Bypass Grafts in the Lower Limb.

Acosta, Stefan LU and Monsen, C (2012) In European Journal of Vascular and Endovascular Surgery 44(3). p.294-299
Abstract
OBJECTIVE: To assess the outcome of vacuum-assisted wound closure (VAC(®)) therapy for infected bypass grafts.



METHODS: A retrospective 7-year review of patient records from 2004 to 2011 of all patients receiving VAC(®) therapy for infected bypass grafts.



RESULTS: Thirty-seven patients with 42 wounds and 45 infected bypass (28 synthetic) grafts received VAC(®) treatment. Two serious bleeding episodes from the suture lines occurred. The median VAC(®) therapy time was 20 days. The proportion of patent bypass grafts was 91% (41/45) at a median time of 3.5 months from the start of VAC(®) therapy. Five patients with seven bypasses had persistent infection or re-infection, and the total graft preservation... (More)
OBJECTIVE: To assess the outcome of vacuum-assisted wound closure (VAC(®)) therapy for infected bypass grafts.



METHODS: A retrospective 7-year review of patient records from 2004 to 2011 of all patients receiving VAC(®) therapy for infected bypass grafts.



RESULTS: Thirty-seven patients with 42 wounds and 45 infected bypass (28 synthetic) grafts received VAC(®) treatment. Two serious bleeding episodes from the suture lines occurred. The median VAC(®) therapy time was 20 days. The proportion of patent bypass grafts was 91% (41/45) at a median time of 3.5 months from the start of VAC(®) therapy. Five patients with seven bypasses had persistent infection or re-infection, and the total graft preservation rate was 76% (34/45). The median follow-up time was 15 months. The presence of two infected bypass grafts in one groin wound was associated with an increased major amputation rate (hazard ratio (HR) 7.4 [95% confidence interval (CI) 2.0-27.5]), and synthetic graft infection (HR 5.0 [95% CI 1.5-17.4]) and non-healed wound (HR 3.6 [95% CI 1.5-8.7]) were associated with mortality.



CONCLUSION: VAC(®) therapy of infected bypass grafts was able to induce effective wound healing without compromising the early bypass function. Two infected synthetic bypasses in the wound were associated with the highest risk of adverse outcome. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Wound, Graft infection, Bypass, VAC, Negative pressure wound therapy, healing, Amputation, Mortality
in
European Journal of Vascular and Endovascular Surgery
volume
44
issue
3
pages
294 - 299
publisher
Elsevier
external identifiers
  • wos:000309303500015
  • pmid:22818802
  • scopus:84865458178
ISSN
1532-2165
DOI
10.1016/j.ejvs.2012.06.005
language
English
LU publication?
yes
id
20979b6e-41c0-43b6-b36b-3a6886bd7827 (old id 2966834)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/22818802?dopt=Abstract
date added to LUP
2012-08-09 21:22:41
date last changed
2017-03-05 04:00:17
@article{20979b6e-41c0-43b6-b36b-3a6886bd7827,
  abstract     = {OBJECTIVE: To assess the outcome of vacuum-assisted wound closure (VAC(®)) therapy for infected bypass grafts. <br/><br>
<br/><br>
METHODS: A retrospective 7-year review of patient records from 2004 to 2011 of all patients receiving VAC(®) therapy for infected bypass grafts. <br/><br>
<br/><br>
RESULTS: Thirty-seven patients with 42 wounds and 45 infected bypass (28 synthetic) grafts received VAC(®) treatment. Two serious bleeding episodes from the suture lines occurred. The median VAC(®) therapy time was 20 days. The proportion of patent bypass grafts was 91% (41/45) at a median time of 3.5 months from the start of VAC(®) therapy. Five patients with seven bypasses had persistent infection or re-infection, and the total graft preservation rate was 76% (34/45). The median follow-up time was 15 months. The presence of two infected bypass grafts in one groin wound was associated with an increased major amputation rate (hazard ratio (HR) 7.4 [95% confidence interval (CI) 2.0-27.5]), and synthetic graft infection (HR 5.0 [95% CI 1.5-17.4]) and non-healed wound (HR 3.6 [95% CI 1.5-8.7]) were associated with mortality. <br/><br>
<br/><br>
CONCLUSION: VAC(®) therapy of infected bypass grafts was able to induce effective wound healing without compromising the early bypass function. Two infected synthetic bypasses in the wound were associated with the highest risk of adverse outcome.},
  author       = {Acosta, Stefan and Monsen, C},
  issn         = {1532-2165},
  keyword      = {Wound,Graft infection,Bypass,VAC,Negative pressure wound therapy,healing,Amputation,Mortality},
  language     = {eng},
  number       = {3},
  pages        = {294--299},
  publisher    = {Elsevier},
  series       = {European Journal of Vascular and Endovascular Surgery},
  title        = {Outcome after VAC(®) Therapy for Infected Bypass Grafts in the Lower Limb.},
  url          = {http://dx.doi.org/10.1016/j.ejvs.2012.06.005},
  volume       = {44},
  year         = {2012},
}