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A passive system using rifampin to create an infection-resistant vascular prosthesis.

Vascular prosthesis infection is a devastating complication of vascular operations. The development of a simple process for imparting infection resistance to vascular prosthesis material would be invaluable. Rifampin was added to the blood that was used to preclot 8 mm Dacron vascular prostheses that were used to replace the infrarenal aorta in 10 mongrel dogs. Rings of the grafts were resected after blood had flowed through them for 0 minute, 15 minutes, 60 minutes, and 24 hours. The resected graft rings were placed on culture plates that had been inoculated heavily with Staphylococcus aureus. The rate of antibiotic dialysis from the graft was determined by comparison of the inhibition rings that were produced by the graft rings at each subsequent interval. At 60 minutes, inhibition was 94% of that at time 0. Inhibition at 24 hours was 91%, which demonstrated no significant decrease from 60 minutes. Other antibiotics were screened by this technique, but none of them demonstrated inhibition at 24 hours. In a pilot study in which two dogs were given parenteral rifampin before and after operation and grafts were preclotted with blood that contained rifampin, it was suggested that there was a slight increase in inhibition at 24 hours (93%). The data indicated that rifampin that is added to the blood that is used to preclot a porous Dacron prosthesis is so slowly dialyzed from the graft that inhibition remains at 24 hours. This passive system imparts potential resistance to the prosthesis.