Incorporation failure of dacron arterial grafts

Abstract

Two cases of impaired Dacron arterial graft incorporation are reported. They were characterized by the presence of an inflammatory reaction with periprosthetic collection rich in cells but with no detectable germs. The patients also showed total lack of systemic symptoms, including humoral signs of altered immune response, and the tendency of well-tolerated external discharge from the collection. Based on these data and on the body's behavior towards a small fragment of the same type of alloplastic material implanted subcutaneously in the forearm of one of these patients, this phenomenon has been interpreted as an intolerance to the graft material, similar to a generic foreign body reaction rather than an immunologic reaction. We think it is extremely important to differentiate this kind of aseptic graft intolerance from graft infections before deciding on adequate treatment. Moreover, our experience and that of other similar cases, collected from the literature, led us to suspect that many cases that are labeled as low-grade infections could not really be infections. The results reported here justify the need to distinguish between infections and intolerance to the graft material.