Antibiotic Prophylaxis in Autologous Vein Graft Reconstructions of the Lower Extremity

Vasc Endovascular Surg. 2015 Jan-Feb;49(1-2):24-9. doi: 10.1177/1538574415585732. Epub 2015 May 13.

Abstract

Background: Different factors contribute to infection after arterial reconstructive surgery. Prophylactic antibiotic use during surgery is widespread, however, there is insufficient evidence to support the use of prophylactic antibiotics with autologous vein grafting. The aim of our study was to assess the effect of single-dose prophylactic antibiotics in patients undergoing autologous vein grafting.

Methods: Patients undergoing arterial bypass reconstruction in the lower extremity between 2004 and 2012 were retrospectively screened for use of vein grafts. Patients receiving single-dose antibiotic prophylaxis (group 1) were compared with those not receiving prophylaxis (group 2).

Results: Primary outcome was surgical site infection (SSI), and 142 patients were included. The SSI occurred in 22% of patients in group 1 and in 29% of patients in group 2 (P = .39; odds ratio: 1.46 confidence interval 95%: 0.61-3.47).

Conclusions: Results showed no significant effect from single-dose antibiotic prophylaxis on lowering the incidence of SSI.

Keywords: antibiotics; infection; lower extremity; vascular reconstruction; venous bypass.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Antibiotic Prophylaxis*
  • Cefuroxime / administration & dosage
  • Chi-Square Distribution
  • Drug Administration Schedule
  • Drug Combinations
  • Female
  • Humans
  • Logistic Models
  • Lower Extremity / blood supply*
  • Male
  • Metronidazole / administration & dosage
  • Middle Aged
  • Multivariate Analysis
  • Netherlands
  • Odds Ratio
  • Peripheral Arterial Disease / surgery*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Retrospective Studies
  • Risk Factors
  • Surgical Wound Infection / diagnosis
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Treatment Outcome
  • Vascular Grafting / adverse effects
  • Vascular Grafting / methods*
  • Veins / transplantation*

Substances

  • Anti-Bacterial Agents
  • Drug Combinations
  • Metronidazole
  • Cefuroxime