Rifampicin-soaked Silver Polyester versus Expanded Polytetrafluoro-ethylene Grafts for In Situ Replacement of Infected Grafts in a Porcine Randomised Controlled Trial

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• 作者：H. Gao^a ; ^{dr.gaohong@gmail.com} ; J. Sandermann^a ; J. Prag^b ; L. Lund^c ; J.S. Lindholt^a
• 关键词：Porcine model ; Aortic graft infection ; Aortic surgery ; Staphylococcus aureus
• 刊名：European Journal of Vascular and Endovascular Surgery
• 出版年：2012
• 期刊代码：122_10785884
• 类别：med
• 出版时间：May, 2012
• 卷：43
• 期：5
• 页码：582-587
• 文件大小：250 K

摘要

Background

To compare the efficacy of in situ replacement with rifampicin-soaked silver-coated polyester (RSSCP) to that of expanded polytetrafluoroethylene (ePTFE) graft replacements in a porcine model for early aortic prosthetic vascular graft infection (PVGI).

Material and methods

Sixty pigs received polyester or silver-coated grafts with an 8聽mm diameter implanted end-to-end in the infrarenal aorta, and the grafts were inoculated with approximately 10⁶ Staphylococcus aureus. All developed S.聽aureus PVGI. Two weeks later, the 52 surviving pigs were randomised to undergo in situ graft replacement with ePTFE or RSSCP grafts followed by oral administration of 300聽mg rifampicin and 750聽mg ciprofloxacin twice a day, postoperatively. After three weeks, all pigs were sacrificed. In situ perigraft swabs and graft material were analysed for S.聽aureus quantitatively.

Results

Only one out of 25 RSSCP grafts were infected with S.聽aureus, whereas 15 of 27 ePTFE grafts were infected after 3 weeks (OR聽=聽0.022, 95%CI: 0.002, 0.219, P聽=聽0.001).

Conclusions

In situ replacement with RSSCP grafts and oral rifampicin plus ciprofloxacin is more efficiency in eradicating S.聽aureus PVGI than ePTFE grafts treated with same oral antibiotics in a porcine aortic PVGI model.