Treatment options for complications in vascular surgery

: The authors processed the patients' data of the last 10 years and present their experience in treating septic complications in the field of vascular surgery. They analyzed the therapeutic possibilities and reviewed the literature. They suggest the following treatment alternatives for the infection related complications, that they consider the best options these days: 1. Identification of the causative agent by microbiologic methods and determination of the antibiotic susceptibility. 2. In the cases of occluded grafts it is recommended to remove the whole graft and to apply a suction-irrigation drainage. 3. In the cases of patent grafts: (a) If the infections starts in the immediate postoperative period it is suggested to spare the graft, open the wound, perform debridement and apply a suction-irrigation drainage. (b) Late suppurations, confined to the trunk of the graft without affecting the anastomoses, requires extensive debridement and lavage, and the graft could be left in place. (c) Anastomosis infection calls for graft removal, in situ reconstruction and suction-irrigation drainage in one setting. (d) Extraanatomic bypass is indicated when culture proves bacteria producing extraprotease enzymes because in these cases the incidence of repetitive septic bleedings are significantly higher, so in situ reconstructions are not recommended.