Does the timing of reoperation influence the risk of graft infection?

Abstract

Early revision of lower extremity arterial bypass grafts has a significantly higher risk of graft infection compared with revision >1 month after surgery. Infection will develop in approximately 25% (9/33) of prosthetic grafts that are reoperated on early. If feasible, reoperation should be delayed >1 month for prosthetic grafts needing revision. Endovascular or extra-anatomic interventions should be considered if early revision is mandated in this group.

Endoscopic vein harvest does not negatively affect patency of great saphenous vein lower extremity bypass

“…24,25 Reoperation in scarred tissue causes lymphatic disruption and increases the risk for hematoma and seroma formation, providing a rich medium for bacterial growth that is poorly penetrated by antibiotics. 26 The impact of prior interventions and obesity has been well described for groin wound complications, and our subgroup analysis confirmed this relationship. However, interestingly, neither factor was found to be independently associated with vein harvest site complications.…”

Risk Factors for Surgical-Site Infection Following Common Femoral Artery Endarterectomy

“…The latter provides a rich medium for bacterial growth in a relatively poor penetrated area for parenteral antibiotics. 13,14 The second independent risk factor is the wound drain. We speculate that the elevated risk of surgicalsite infection is probably a result of direct contamination with virulent organisms, such as Staphylococcus epidermidis and S aureus, by creating a prolonged port of entrance between the contaminated skin and the operated on area.…”

Surgical Site Infection after Multiple Groin Incisions in Peripheral Vascular Surgery

“…Kolakowski et al reported early revision of lower extremity bypass grafts (within one month), compared with late revision (after one month) to be a risk factor for graft infection [11] and stated reintervention should be delayed until one month after initial surgery. Unfortunately, in most cases, revision surgery cannot be delayed because of severe, even critical, limb ischemia [12].…”