AORTIC PROSTHETIC INFECTION - 50 PATIENTS TREATED BY RADICAL OR LOCALSURGERY

Fifty patients with aortic prosthetic infection were managed in a peri od of 10 years from 1983 to 1993. Twenty-five patients had recurrent s epsis after local surgery (group 1) and 22 of these eventually require d radical surgery. Twenty-five patients had radical graft excision as the first procedure (group 2). Group 1 contained an excess of patients with local groin symptoms (11 in group 1 versus five in group 2, P = 0.03) and in this group fewer radiological techniques were used to doc ument the extent of graft infection. The perioperative mortality rate was similar in both groups (seven in group 1 versus five in group 2). The number of amputations was also similar (five in group 1 versus fou r in group 2), The triad of occlusive disease, aortobifemoral bypass a nd groin symptoms was associated with eight of nine amputations. While the authors would consider using Local techniques if the anastomosis was intact, the graft remained patent and infection appeared to be con fined to the groin, this combination is uncommon and radical graft exc ision remains the preferred treatment.