Management of Vascular Graft Infection

Harry Ward, D. Howard
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Abstract

This case report focuses on the risk factors, diagnosis, and management of vascular graft infections. A complex and intriguing case is presented and the latest evidence on aetiology and management of this challenging condition are summarised. The contention regarding the diagnostic criteria for graft infection is addressed, and how different imaging modalities and genetic or systemic biomarkers could aid this diagnostic process. Key management challenges are also discussed. Firstly, the difficulties of penetration and efficacy of antimicrobials and the issues surrounding biofilm formation. Secondly, the different surgical options such as graft preservation with partial excision or muscle flap coverage, or excision and revascularisation. Further, the type of explant and the latest innovations in the field of biological grafts are considered. Overall, this case report brings to the fore the lack of structured guidelines and level 1 evidence for the diagnosis and management of vascular graft infection, and calls for a more structured, unified, multi-disciplinary approach.
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血管移植感染的处理
本病例报告的重点是血管移植感染的危险因素,诊断和管理。提出了一个复杂而有趣的病例,并总结了这一具有挑战性的疾病的病因和管理的最新证据。关于移植物感染诊断标准的争论得到了解决,以及不同的成像方式和遗传或系统生物标志物如何有助于这一诊断过程。还讨论了关键管理挑战。首先,抗菌剂渗透和功效的困难以及围绕生物膜形成的问题。其次,不同的手术选择,如移植物保留部分切除或肌瓣覆盖,或切除和血运重建术。此外,还介绍了外植体的类型和生物移植物领域的最新进展。总的来说,本病例报告突出了血管移植感染诊断和管理缺乏结构化指南和一级证据,并呼吁建立更结构化,统一,多学科的方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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