Surgical Site and Graft Infections in Endovascular and Open Abdominal Aortic Aneurysm Surgery

Langenberg, Jasper C M; Kluytmans, Jan; Groot, Hans G.W. de; Ho, Gwan H.; Veen, Eelco J.; Buimer, M.G.; Laan, Lijckle van der

doi:10.1089/sur.2017.302

Cited by 5 publications

(7 citation statements)

References 16 publications

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“…While our data were not sufficient to provide complete follow-up data of graft infections, earlier research shows that SSI is a risk factor for the development of aortic graft infection. 12,29 The vast majority (96%) of our study population was treated with bypass grafting. The literature reports overall incidences of graft infection between 0.6% and 3.0%, and up to 4.3% after open reconstructive graft surgery for aneurysmal disease.…”

Section: Discussionmentioning

confidence: 99%

“…The literature reports overall incidences of graft infection between 0.6% and 3.0%, and up to 4.3% after open reconstructive graft surgery for aneurysmal disease. 12,[30][31][32][33] If these numbers can be extrapolated, we expect an even higher incidence of graft infections in the long-term follow-up of open bypass surgery in aortoiliac occlusive disease, due to the higher incidence of SSI in this group. In agreement with other studies, 1 the duration of hospital stay was significantly longer for patients who developed an SSI.…”

Section: Graft Infectionsmentioning

confidence: 99%

“…Prosthetic graft infection is a severe complication associated with high amputation rates (11%) and mortality varying between 20% and 40%. [9][10][11][12] Recent research has shown a link between SSI and the development of aortic graft infection in abdominal aneurysm surgery. 12 This study evaluates the incidence and nature of SSI following open aortoiliac surgery for either aneurysmal or occlusive arterial disease.…”

Section: Introductionmentioning

confidence: 99%

“…[9][10][11][12] Recent research has shown a link between SSI and the development of aortic graft infection in abdominal aneurysm surgery. 12 This study evaluates the incidence and nature of SSI following open aortoiliac surgery for either aneurysmal or occlusive arterial disease. Since occlusive arterial disease is related to microcirculatory dysfunction, [13][14][15] it might have a negative impact on wound healing and therefore the development of SSI.…”

Section: Introductionmentioning

confidence: 99%

“…9 -12 Recent research has shown a link between SSI and the development of aortic graft infection in abdominal aneurysm surgery. 12…”

Section: Introductionmentioning

confidence: 99%

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Do Surgical Site Infections in Open Aortoiliac Surgery Differ Between Occlusive and Aneurysmal Arterial Disease?

Langenberg

Roijers

Kluytmans

et al. 2020

Vasc Endovascular Surg

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Background: Surgical site infections (SSI) are frequently seen after aortoiliac vascular surgery (2%-14%). Deep SSIs are associated with graft infection, sepsis, and mortality. This study evaluates the difference in incidence and nature of SSI following open aortoiliac surgery for aneurysmal disease compared to occlusive arterial disease. Methods: A retrospective cohort study was conducted, including all consecutive patients who underwent open aortoiliac vascular surgery between January 2005 and December 2016 in the Amphia Hospital, Breda, the Netherlands. Patients were grouped by disease type, either aneurysmal or occlusive arterial disease. Data were gathered, including patient characteristics, potential risk factors, and development of SSI. Surgical site infections were defined in accordance with the criteria of the Centers for Disease Control. Results: Between January 2005 and December 2016, a total of 756 patients underwent open aortoiliac surgery of which 517 had aortoiliac aneurysms and 225 had aortoiliac occlusive disease. The group with occlusive disease was younger, predominantly male, and had more smokers. After exclusion of 228 patients undergoing acute surgery, the SSI rate after elective surgery was 6.2%, with 10 of 301 SSIs in the aneurysmal group (3.0%) and 22 of 213 SSIs in the group with occlusive disease (10.3%, P < .001). Also, infection-related readmission and reintervention were higher after occlusive surgery, 6.6% versus 0.9% ( P < .001) and 4.2% versus 0.9% ( P = .003), respectively. Staphylococcus aureus was found as the most common pathogen, causing 64% of SSI in occlusive disease versus 10% in aneurysmal disease ( P = .005). Logistic regression showed occlusive arterial disease and chronic renal disease were associated with SSI. Conclusion: Our study presents evidence for a higher rate of SSI in patients with aortoiliac occlusive disease compared to aortoiliac aneurysmal disease, in part due to inherent use of inguinal incision in patients with occlusive disease. All precautions to prevent SSI should be taken in patients undergoing vascular surgery for arterial occlusive disease.

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Section: Discussionmentioning

confidence: 99%