Abstract
A 62-year-old man was operated for inflammatory abdominal aortic aneurysm through a median transperitoneal approach and was discharged. He returned 3 months later with signs of graft infection. He was re-explored through a left retroperitoneal approach, the remnant of previously left aneurysmal wall was resected as much as possible with extended debridement of necrotic tissues. The wound was thoroughly irrigated, then packed by sponges soaked with 10% iodine solution. This maneuver was repeated 6 times every 8 hours. After 48 hours, the left dorsal latissimus muscle was removed with the attachment of vascular pedicles and transpositioned to the retroperitoneal space around the graft. Vascular anastomoses were made to the inferior epigastric artery and vein. The wound was closed but drainage tubes were left in place. Although prolonged periods were required for the complete healing, he was eventually discharged with “in-situ” preservation of the original graft with no infectious signs. The recurrence of infection was not observed and he is doing well at over 5 years.
