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Background and objectives: Treatment of a prosthetic vascular graft infection (PVGI) remains a challenging problem in vascular surgery. The aim of this study was to design a novel rat model for treatment of peripheral vascular prosthesis infection caused by Staphylococcus aureus (S. aureus) and to determine the efficacy of different antiseptic solutions in suppressing or eradicating infection from the wound and the graft material itself. Materials and methods: A piece of Dacron vascular prosthesis was surgically implanted at the dorsum of 48 Wistar rats and the wounds were infected with 5 McFarland standard inoculum of S. aureus. Suppurating wounds were daily irrigated with different antiseptic solutions: octenidine dihydrochloride, povidone-iodine, chlorhexidine digluconate, and sterile saline. The antimicrobial action of antiseptics was defined according to their capability to eradicate bacteria from the graft surroundings and bacteriological examination of the graft itself. Extended studies on wound microbiology, cytology, and histopathology were performed with an additional group of 10 rats, treated with the most effective antiseptic-octenidine dihydrochloride. Results: Four-day treatment course with octenidine, povidone-iodine, and chlorhexidine resulted in 99.98% (p = 0.0005), 90.73% (p = 0.002), and 65.97% (p = 0.004) decrease in S. aureus colonies in wound washouts, respectively. The number of S. aureus colonies increased insignificantly by 19.72% (p = 0.765) in control group. Seven-day treatment course with octenidine eradicated viable bacteria from nine out of 10 wound washouts and sterilized one vascular graft. Conclusions: A reproducible rat model of PVGI with a thriving S. aureus infection was designed. It is a first PVGI animal model where different antiseptic solutions were applied as daily irrigations to treat peripheral PVGI. Seven-day treatment with octenidine eradicated bacteria from the wound washouts for 90% of rats and one vascular graft. Further studies are needed to investigate if irrigations with octenidine could properly cure vascular bed from infection to assure a successful implantation of a new synthetic vascular substitute.

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Surgery of venous malformations in the extremities ConclusionsThe correct method of treatment was chosen on the background of vascular imaging. Operations resulted in palliation or vanishing of symptoms in most patients. Ávadas/tikslasVenø raidos defektø diagnozë turi bûti nustatyta kuo ankstesniu gyvenimo laikotarpiu. Daugelis ðios ligos simptomø ir poþymiø gali bûti priskirti paprasèiausiai venø varikozei arba hemangiomai. Todël chirurginis gydymas gali bûti nevisavertis ir sukelti tolesná galûniø kraujotakos blogëjimà. Ðio tyrimo tikslas buvo parodyti tikslios diagnozës svarbà, kad bûtø iðvengta klaidø vertinant kraujotakos sutrikimø kilmae ir parenkant tinkamà gydymo metodà. Ligoniai ir metodaiIðanalizuoti anamnezës duomenys 32 ligoniø, operuotø Vilniaus universiteto kraujagysliø chirurgijos centre nuo galûniø venø raidos sutrikimø. Buvo ávertinti operacijø, kurias atliko bendrosios chirurgijos specialistai, ir operacijø, atliktø nustaèius kraujotakos sutrikimø kilmae, rezultatai. Atlikti ðie diagnostikos veiksmai: ultragarso dvigubas skenavimas (32), arteriografija (15), flebografija (30), magnetinis branduoliø rezonansas (6), kompiuterinë tomografija (4 ligoniams). Chirurginá gydymà sudarë flebektomija, marginalinës venos ekstirpacija arba jos ðakø perriðimas, giliøjø nekamieniniø veniniø dariniø paðalinimas. RezultataiEdema buvo 26, opos 2, skausmai 22 ligoniams. Kamieniniai defektai buvo 17, o nekamieniniai -15 ligoniø. Dvylika ligoniø buvo operuoti bendrosios chirurgijos specialistø nenustaèius, kad kraujotakos sutrikimø prieþastis -ágimta kraujagysliø liga. Ðios operacijos nepagerino periferinës kraujotakos. Stazë sumaþëjo arba iðnyko 17 (65,4%) ligoniø, operuotø Kraujagysliø chirurgijos centre, opos uþgijo 2 (100%), skausmas praëjo16 (72,7%) ligoniø. IðvadosTinkamas gydymo metodas buvo parinktas remiantis kraujagysliø vaizdo metodais. Operacijos palengvino arba visai paðalino ligos simptomus daugeliui ligoniø.Reikðminiai þodþiai: kraujagysliø raidos defektai, simptomai ir poþymiai, kraujagysliø vaizdo metodai, chirurginis gydymas