The surgical treatment of hemodialysis arteriovenous graft infection

Objective The purpose of this study was to perform a retrospective evaluation of surgical treatment for arteriovenous graft (AVG) infection. Methods Retrospective analysis of clinical data collected from 18 AVG infection cases between October 2008 and July 2017 was performed. The cases were treated by total graft excision (TGE), subtotal graft excision (SGE) or debridement followed by negative pressure wound therapy (NPWT). All the patients have been followed up. Results 12 of the cases were treated by TGE, 5 by SGE and 1 by local debridement of AVG followed by NPWT. Median follow-up time in this group was 19 months (range 1 month to 96 months). All patients had no bleeding or obvious manifestations of hand ischemia. Recurrence of infection occurred in 1 case with the treatment of NPWT was treated by SGE later. Conclusion AVG infection is the most serious complication of AVG. AVG infection with systemic infection needs to perform TGE as soon as possible. SGE is an alternate treatment for the patients with limited and mild infection without involving the arterial anastomoses of AVG. While debridement followed by NPWT for AVG preservation is not recommended. Key words: Arteriovenous graft; Infection; Hemodialysis; Surgical treatment; Operation