Management of infection in vascular procedures

This study included 31 patients with septic wound problems following various vascular procedures. Staphylococcus aureus was the commonest causative organism cultured from 60% of cases. The presentation of infection was variable, the commonest being superficial wound infection [41.9%] successful management depended upon the early detection and interference before the infection reached the graft or the suture line as well as the proper choice of the lines of therapy. For superficial infections conservative measures were sufficient. However, in deep infections, graft removal was indicated in cases where the graft was bathed in pus thrombosed or when secondary hemorrhage occurred. Extra anatomical bypasses were done following graft excision only when limb threatening ischemia occurred. Attempts at saving the graft was done when it was patent not bathed in pus and not chronically inflamed. In these cases, timely wound excision and flap coverage proved to be the most successful form of therapy