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Reducing graft infection for vascular patients

How antimicrobial vascular grafts could help to reduce the risk of infection

In-vitro studies show that adding an antimicrobial graft to the protocol of care could help to reduce the risk of infection for your vascular patients.[1]

Topics

The impact of infections

Graft infections are associated with high mortality rate between 15% to 75% and with a high rate of major amputation.[2] The majority of vascular graft infections occur at the time of implant or in the immediate postoperative period.[3]

  • Overall reported graft infection rate: 0.5 - 6%.[3][4]
  • Overall reported endovascular aortic repair (EVAR) infection rate: 0.2 - 5%.[3][4]
  • Greater than 90% of patients have one or more risk factors for the development of graft infection.[3][4]

In-vitro findings in vascular grafts

In in-vitro studies, there is proven rapid resistance against rifampicin, where rifampicin loses efficacy over time.[1] Furthermore a antimicrobial graft (with silver acetate and triclosan):

  • has a faster in-vitro bactericidal and antifungal effect compared to only silver.[5][6]
  • has demonstrated a more sustainable and efficient seven-day antimicrobial activity than rifampicin soaked grafts.[1]
Faster in-vitro bactericidal and antifungal effect (24 hr)

In-vitro antimicrobial efficacies evaluated by time-kill assays at 24 hours.[1] Abbreviations: IG = Intergard without antimicrobials, IGrif = Intergard without antimicrobials, rifampicin soaked, IGSy = Intergard Synergy with two antimicrobials, (silver acetate and triclosan).

More sustainable and efficient seven-day antimicrobial activity (168 hr)

In-vitro antimicrobial efficacies evaluated by time-kill assays at 168 hours.[1] Abbreviations: IG = Intergard without antimicrobials, IGrif = Intergard without antimicrobials, rifampicin soaked, IGSy = Intergard Synergy with two antimicrobials (silver acetate and triclosan).

How an antimicrobial graft works

For prophylactic use, an antimicrobial graft is designed to inhibit the microbial colonization on the device and in the surrounding tissues in the acute post-operative phase.[5][7] Combining silver acetate and triclosan:

  • enlarges the spectrum of activity[1]
  • reduces the risk of resistance[1]

Learn more 

Contact us to learn more or read more about Intergard Synergy, the first vascular prosthesis combining two well-known antimicrobial agents: silver acetate and triclosan.

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Les mer

Alle referanser

  1. Berard X, et al. In vitro Evidence of Improved Antimicrobial Efficacy of Silver and Triclosan Containing Vascular Grafts Compared with Rifampicin Soaked Grafts. European Journal of Vascular and Endovascular Surgery 57, March 2019; 424 – 432.

  2. Legout L, et al. Diagnosis and Management of Prosthetic Vascular Graft Infections. Médecine et Maladies Infectieuses; 42 (2012): 102–109.

  3. Ricco JB, et al. In Vitro Evaluation of the Antimicrobial Efficacy of a New Silvertriclosan vs a Silver Collagen-Coated Polyester Vascular Graft Against Methicillin-Resistant Staphylococcus Aureus. Journal of Vascular Surgery, March 2012; 55(3):823-829.

  4. Smeds m, et al. Treatment and Outcomes of Aortic Endograft Infection. Journal of Vascular Surgery, February 2016; 332 – 340.

  5. Ricco JB, Assadian O. Antimicrobial Silver Grafts for Prevention and Treatment of Vascular Graft Infection. Seminars in Vascular Surgery 24, 2011; 234 – 241.

  6. Berard X, et al. Comparison of the Antimicrobial Properties of Silver Impregnated Vascular Grafts With and Without Triclosan. European Journal of Vascular and Endovascular Surgery 51, 2016; 285 – 293.

  7. Data on file.