Laparoscopic Diagnosis and Treatment of Aortic Vascular Prosthetic Graft Infections in a Porcine Model

• Published in: European journal of vascular and endovascular surgery Vol. 35; no. 1; pp. 41 - 45
• Main Authors: Gao, H, Lund, L, Prag, J, Sandermann, J, Lindholt, J.S
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-01-2008
• Subjects: Animals; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Aorta - surgery; Aortic graft infection; Aortic surgery; Blood Vessel Prosthesis - adverse effects; Blood Vessel Prosthesis Implantation - instrumentation; Ciprofloxacin - therapeutic use; Debridement; Disease Models, Animal; Drug Therapy, Combination; Feasibility Studies; Female; Laparoscopy; Porcine model; Prosthesis-Related Infections - diagnosis; Prosthesis-Related Infections - drug therapy; Prosthesis-Related Infections - surgery; Rifampin - therapeutic use; Staphylococcal Infections - diagnosis; Staphylococcal Infections - drug therapy; Staphylococcal Infections - surgery; Staphylococcus aureus; Surgery; Swine; Time Factors; Aortic graft infection; Laparoscopy; Aortic surgery; Staphylococcus aureus; Porcine model
• ISSN: 1078-5884; 1532-2165
• DOI: 10.1016/j.ejvs.2007.07.005

Objectives To study the feasibility and efficacy of experimental laparoscopy in the diagnosis of aortic graft infection in pigs. Material and methods Eight pigs had an aortic tube graft implanted and inoculated with either 5 × 104 or 106 CFU of Staphylococcus aureus ATCC 29213. Laparoscopy was performed after a median of 20 days with debridement and sampling for bacterial culture. Thereafter, the grafts were locally soaked in rifampicin and postoperatively, the pigs received rifampicin and ciprofloxacin orally for two weeks and were then sacrificed. Results All pigs developed graft infection. One pig died from severe clostridial septicaemia before laparoscopy could be performed. The remaining pigs had all samples for bacterial culture taken by laparoscopy from the inflamed tissue. The temperature dropped significantly after laparoscopy, and no macroscopic signs of infection presented at autopsy. However, only culture from one pig was without S. aureus at autopsy. Conclusions Laparoscopy is a potential diagnostic tool for aortic graft infection and also affords the opportunity to carry out bacteriological sampling and local antibiotic treatment. The efficacy of laparoscopic treatment needs further evaluation.