Zusammenfassung
Die Infektionen, insbesondere aber der Protheseninfekt, stellen in der rekonstruktiven Gefäßchirurgie eine der am meisten gefürchteten Komplikationen dar. Am häufigsten ist die Leistenregion von einer solchen Infektion betroffen. Da alloplastische Implantate normalerweise keine Infektresistenz aufweisen, sind Infektionen in diesem Fall als weitaus bedenklicher einzustufen als bei Verwendung von autologen Venentransplantaten. Die Diagnostik erfolgt primär klinisch unterstützt durch bildmorphologische Korrelate und mikrobiologische Untersuchungen. Der Erregernachweis ist dabei erschwert, häufig finden sich nur unzureichende Ergebnisse. Therapeutisch sollte eine Komplettentfernung der infizierten Gefäßprothesen stets angetrebt werden. In Situ Rekonstruktionen mit autologen und allogenen Transplantaten sind zu bevorzugen. Silberbeschichtete und antibiotikagetränkte Kunststoffprothesen bieten Alternativen mit eingeschränktem Outcome. Die Rekonstruktion mit extraantomischen Bypässen ist ausgewählten Indikationen vorgehalten. Eine Antibiotikatherapie ist für mindestens 4 Wochen bis 6 Monate nach erfolgreicher Operation fortzuführen.
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Diener, H., Assadian, O., Zegelman, M., Steinbauer, M., Debus, E.S., Larena-Avellaneda, A. (2020). Gefäßprotheseninfektionen. In: Debus, E., Gross-Fengels, W. (eds) Operative und interventionelle Gefäßmedizin. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-53380-2_114
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