Management of Vascular Infections in Low- and Middle-Income Countries

Surg Infect (Larchmt). 2020 Sep;21(7):559-570. doi: 10.1089/sur.2020.117. Epub 2020 Jul 15.

Abstract

Background: Vascular infections are rare and challenging conditions with significant deaths and morbidity. Their management necessitates a multi-disciplinary approach and substantial human and financial resources. The management selected may be influenced by the available resources in low- and middle-income countries (LMICs), where such resources may be variable. Methods: We reviewed the published literature and reviewed the management options for various vascular infections with a focus on carotid, aortic, infrainguinal, and dialysis access infections. Results: Recommendations related to prevention and treatment will be offered from the perspective of LMICs. The general principles for prevention are in compliance with established surgical site infection guidelines and minimize the use of prosthetic material. Early detection and intervention by removing all infected prosthetic material, debridement, drainage, and coverage of the infected field with vascularized tissue are essential steps in the management of the infection. Revascularization using an extra-anatomic or in situ approach is individualized based on the resources and expertise available. Conclusions: The prevention and management of vascular infections in LMICs are effective by adhering to time-proven principles even with limited resources.

Keywords: aortic graft infections; carotid patch infections; dialysis access infections; endovascular graft infections; low- and middle-income countries; vascular infections.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Antibiotic Prophylaxis / methods
  • Blood Vessel Prosthesis / adverse effects*
  • Blood Vessel Prosthesis / microbiology
  • Blood Vessel Prosthesis Implantation / adverse effects*
  • Catheter-Related Infections / prevention & control
  • Catheter-Related Infections / therapy
  • Developing Countries*
  • Diabetes Mellitus / epidemiology
  • Humans
  • Operative Time
  • Prosthesis-Related Infections / microbiology
  • Prosthesis-Related Infections / prevention & control*
  • Prosthesis-Related Infections / therapy*
  • Renal Dialysis / adverse effects
  • Reoperation
  • Risk Factors
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control
  • Surgical Wound Infection / therapy

Substances

  • Anti-Bacterial Agents