INTRALYMPHATIC ANTIBIOTIC DELIVERY FOR REDUCING ACUTE PROSTHETIC GRAFT INFECTION

The lymphatic system has been implicated as a source of synthetic graf t contamination when grafts are implanted in the presence of a distal septic focus. In previous studies, radical lymphatic excision and liga tion were shown to reduce acute graft sepsis. However significant lymp hedema precluded its clinical application. The present study was under taken to evaluate methods for reducing acute -raft sepsis while avoidi ng lymphatic obstructive complications. Twenty dogs were divided into one control and two experimental cohorts. Femoral interposition grafts were placed in each dog. A hind paw septic focus was introduced and t herapy included a control (Group I - no therapy), intravenous antibiot ics in Group II and intralymphatic antibiotics in Group III. Graft, bl ood and tissue cultures from each dog were taken at 48 hours. Lymphati c antibiotic therapy resulted in significantly improved graft culture results when compared to the control (p=0.0003) and intravenously trea ted animals (p=0.007). Blood cultures in the intralymphatically treate d group were also significantly better (p=0.003) than the control grou p.