ABSTRACT
Introducción. La infección protésica inguinal es una complicación grave que pone en riesgo la extremidad revascularizada, y su solución resulta compleja en muchas ocasiones, incluso en las mejores situaciones. Caso clínico. Varón de 56 años con varias cirugías revascularizadoras en ambos miembros inferiores y ausencia de vena autóloga. Presenta antecedente de infección precoz en una prótesis femoropoplítea tratada con retirada parcial. Acude por infección inguinal con bypass femoropoplíteo infragenicular compuesto (politetrafluoroetileno-vena safena interna) permeable. Se realizó un amplio desbridamiento de la zona, con la retirada de la prótesis residual, y se implantó un bypass ortoanatómico con aloinjerto arterial criopreservado y posterior cobertura con flap muscular rotacional (recto anterior-sartorio) e injerto cutáneo parcial. Visto en una revisión a los tres meses con permeabilidad del bypass y buena integración del injerto. Conclusión. En caso de infección protésica, asociada a gran afectación tisular, y ausencia de material autólogo para su sustitución, el empleo de un aloinjerto arterial criopreservado con posterior cobertura con un flap muscular y cutáneo se presenta como una opción válida en su manejo
Introduction. Inguinal graft infections constitute a severe complication that puts the revascularised limb at risk and they are often difficult to resolve, even in the best situations. Case report. A 56-year-old male who had previously undergone several revascularisation operations in both lower limbs and had no autologous veins. The patient had previously suffered early infection of a femoral-popliteal graft which was treated by means of partial withdrawal. He visited because of an inguinal infection with a compound (polytetrafluoroethylene-great saphenous vein) below-theknee femoral-popliteal bypass that was seen to be patent. The procedure consisted in wide debridement of the area, with removal of the residual graft, and an anatomic bypass was implanted with a cryopreserved arterial allograft and later covered with a rotational muscular (rectus femoris-sartorius) flap and partial skin graft. In a control visit at three months, the bypass was seen to be patent and the graft was well integrated. Conclusions. In cases of infection of a prosthetic graft, associated with widespread tissue involvement, and the absence of autologous material with which to replace it, use of a cryopreserved arterial allograft that is later covered with a muscle and skin flap has proved to be a valid management option
Subject(s)
Male , Middle Aged , Humans , Transplantation, Homologous/methods , Infections/complications , Pelvic Infection/surgery , Pelvic Infection , Cryopreservation/methods , Tomography, Emission-Computed/methods , Vancomycin/therapeutic use , Imipenem/therapeutic use , Transplantation, Homologous/instrumentation , Transplantation, Homologous/trends , Cryopreservation/trends , Saphenous Vein/surgery , Saphenous Vein , Inguinal Canal/pathology , Inguinal Canal/surgeryABSTRACT
Results of a study about the chronic ischaemia of the lower limbs and its correlation with age, sex and previous diagnosis, are presented. Also, a comparison between previous diagnosis and results following the methodology exposed, was made. Study group included 433 older patients, randomizadely selected and permanent residents of some geriatric centers of the Oriental Andalucy.
Subject(s)
Ischemia/epidemiology , Leg/blood supply , Aged , Aged, 80 and over , Arterial Occlusive Diseases/epidemiology , Chronic Disease , Humans , Incidence , Prevalence , Sex Factors , Spain/epidemiologyABSTRACT
Because the high incidence of cardiovascular disease between aged people and because the problematic features of Andalusian community, like its vast extension, high percentage of people older than 65 years, low sociocultural level and lack of physicians specialized on Angiology; an important study was made in order to analyze such type of disorders as well as their factors of risk. Study was made transversally with 443 hospitalized aged patients.
Subject(s)
Vascular Diseases/epidemiology , Age Factors , Aged , Cross-Sectional Studies , Cultural Characteristics , Humans , Prevalence , Risk Factors , Sex Factors , Spain/epidemiologyABSTRACT
Sanguineous flow is studied in a group of patients with unilateral obliteration of iliac artery. This flow was particularly studied during exercise with the purpose of determinate the modifications on the flow produced by exercise. For this purpose, 11 patients with no associated pathologies were studied during more than a year follow-up.