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Maciej Kielar, Andrzej Lewczuk and Wojciech Tur

Treatment of Vascular Prosthesis Infections — 15 Years of Experience

The aim of the study was to present the results of treatment for vascular prosthesis infections.

Material and methods. From January 1993 until January 2008, 47 patients were treated at Department of General and Vascular Surgery Bródnowski Hospital due to symptomatic, late vascular graft infections. The most common local symptoms were groin abscesses, often with bleeding complications. All patients with diagnosed vascular prosthesis infections were treated operatively.

Results. Fifty-three operations were performed, resulting in the regression of infection symptoms in 17 cases (63%), with 37% of cases leading to amputation. Mortality in the patients examined amounted to 37%; 46.4% of cases displayed recurrent infection. The period of hospital treatment oscillated between 12 to 221 days (av. 74 days).

Conclusions. 1. Aggressive operative treatment of vascular prosthesis infections is burdened by high percentages of recurrence and amputation. 2. Less radical operative treatment techniques yield similar results. 3. A uniform protocol for diagnosed vascular prosthesis infection is currently lacking.

Open access

Wojciech Tur, Maciej Kielar, Agata Kłaczkowska, Edyta Teodorowicz and Andrzej Lewczuk

Nasal Carriage of MRSA Strains Among Hospital Employees in a Surgical Department

The aim of the study was to estimate the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) strain carriage among hospital employees who have contact with patients treated at the General and Vascular Surgery Teaching Hospital of the Capital Bródnowski Hospital. Comparison of the findings with results from similar studies performed in various medical centers around the world.

Material and methods. Using microbial cultures, we screened for nasal carriage of MRSA strains in hospital employees who have contact with patients at the General and Vascular Surgery Teaching Hospital. The medical and custodial staff of the Faculty of General and Vascular Surgery, Anesthesiology and Operating Suite were studied. If MRSA strains were present on bacterial cultures, identification of the strain was further confirmed using molecular methods, including reverse transcription polymerase chain reaction (RT-PCR). Examinations were performed in collaboration with the Department of Epidemiology and Clinical Microbiology of the National Medicines Institute.

Results. The carriage rate confirmed by molecular techniques was 4.5%. Confirmed cases of MRSA carriage in hospital staff underwent eradication with a five-day treatment scheme of intranasal 2% mupirocin ointment. Control results confirmed its effectiveness.

Conclusions. The prevalence of nasal carriage of MRSA among the medical and custodial staff screened was 4.5%. This prevalence of carriage among medical employees is similar to the rate of carriage in the general population. This finding suggests a low rate of bacterial transmission between the faculty, staff, and patients. Eradication of MRSA with the use of a five-day course of 2% intranasal mupirocin ointment is an effective method of controlling carriage among medical staff as well as among the general public.

Open access

Maciej Kielar, Maria Noszczyk, Jacek Waligóra, Andrzej Lewczuk and Wojciech Tur

Evaluation of Telangiectasia Treatment Results Using an Electro-Optical Synergy Method

ELOS technology uses a simultaneous activity of a semi-conductor laser light and bipolar current of high radiofrequency (RF). The laser energy is absorbed by hemoglobin in the dilated vessels through a selective photothermolysis. Energy of the radiofrequency current, conducted through the skin, heats the vessel up until it reaches the temperature which destroys it. This technology is the basis of safe and effective ablation of small vascular lesions up to 4 mm in diameter.

The aim of the study was evaluation of treatment results with application of a combined percutaneous technique using synergistic RF frequency activity and a diode laser.

Material and methods. One -hundred and fifty women ages 23 to 68 years (mean=41.1) qualified for the treatment. None of the patients had a history of deep venous insufficiency. Electro-optical synergy (ELOS) technology was used as a treatment approach. The time for the procedure ranged from 10 to 30 minutes (average=18 min.). Treatment results were evaluated after 30 days using both a four-point medical evaluation scale and a four-point subjective assessment-of-satisfaction scale. The degree of pain accompanying the procedure was also determined.

Results. In a medical evaluation, after all procedures were complete, 102 very good results were obtained (68%) and we did not succeed in 48 cases (32%). In a subjective evaluation, 120 (80%) very good or good and 25 (16.6%) unsatisfactory assessments were obtained. The results of the treatment were assessed as satisfactory by 5 patients (3.4%).

Conclusions. 1. The ELOS technique is an efficient and safe method of telangiectasia treatment. 2, The ELOS technique gives a high percentage of good and very good treatment results, both in medical evaluations and patients' subjective assessments.