Infected Grafts Flashcards
MC organism responsible for infected grafts
Staph aureus
What other organisms are common in infected grafts
MRSA, E coli, Enterobacter, Klebsiella, Proteus, Psuedomonas
Late infections are commonly caused by which organisms
S. epidermidis
What organism produces a polysaccharide biofilm
S. epidermidis
How can local infection present
sinus tract, perigraft fluid collection, anastomotic pseudoaneurysm, aortoenteric fistula
Define late graft infection
greater than 4 months after graft implantation
If a patient presents with GI hemorrhage and known intraabdominal graft what diagnosis should be assumed
aortoenteric fistula
Where can an aortoenteric fistula be located
anywhere within the bowel, MC 3rd and 4th portion of the duodenum
Diagnostic imaging of aortoenteric fistula
Duplex US, CT, MRI
What test should be promptly performed in a patient with UGI hemorrhage and a graft
upper endoscopy
When complete excision of a graft is required what are the surgical options
- ax-bifem, 2. bilateral ax-profunda, 3. bilateral ax-popliteal 4. bilateral ax-superficial femoral bypass
If UGI is negative for aortoenteric fistula should further workup be done
yes
Is the risk of limb loss greater with an infrainguinal prosthetic graft
yes
When can graft salvage be considered
if no systemic sepsis, thrombosis, septic emboli or Psuedomonas
What is the approach to graft salvage
local debridement, IV abx and local abx, muscle flaps for coverage
