NPWT for a localized distal anastomotic infection after bifurcated aortofemoral bypass: A case series

The classic treatment for periprosthetic infection in vascular surgery is prosthesis explantation with bypass grafting using autologous material or extra-anatomical bypass of the affected area. However, in some cases, conservative management is advisable. One of the modern methods for the conservative therapy of periprosthetic infection is Negative Pressure Wound Therapy (NPWT). However, current guidelines for the treatment of vascular graft infections do not establish clear guidelines for NPWT. Objective. The aim of the study is to evaluate the NPWT results in patients with localized periprosthetic infection of the distal anastomosis after bifurcated aortofemoral bypass. Materials and Methods. The study included 8 patients (6 (75 %) men, 2 (25 %) women, mean age 68±5). All the patients underwent NPWT for 6–10 days. Etiotropic antibiotic therapy was administered concurrently. Observations were conducted from 2018 to 2024. The study proposes selection criteria for patients indicated for conservative treatment of periprosthetic infection, as well as an internal clinical protocol for managing such patients. The authors analyze current medical literature on this issue, and compare the available data with those obtained during the description of the presented case series. Results. In all cases, complete wound healing was achieved. No bleeding was observed during vacuum therapy. The follow-up period ranged from 9 to 26 months. No prosthesis re-infections, mortality, or amputations were observed in the study group.