Infectious complications after open reconstructive surgery on the aorta and lower limb arteries in patients receiving pulsed electromagnetic therapy: A historically controlled study

Introduction. Infectious complications after reconstructive surgery on the aorta and lower limb arteries using synthetic materials are among the most severe complications of vascular surgery, while the spread of antimicrobial resistance and impaired tissue barrier function in chronic ischaemia limit the effectiveness of antibiotic prophylaxis. Aim. To compare the incidence and pattern of healthcare-associated infections (HAI) and the microbial spectrum in patients after open reconstructive surgery on the aorta and lower limb arteries with and without non-invasive pulsed electromagnetic therapy. Materials and methods. A prospective non-randomised single-centre study with historical controls was conducted at the Republican Clinical Medical and Surgical Centre (Nalchik). The EMF (electromagnetic fields) group consecutively enrolled 20 patients with grade III–IV chronic lower limb ischaemia (Pokrovsky – Fontaine classification) operated on in January – October 2025; from admission until discharge they received electromagnetic therapy sessions with the TOR device (at least 5 days, at least 4 h daily, “15 + 15” min mode). The comparison group included 19 patients without electromagnetic therapy and matched by type of surgery, conduit material and ischaemia grade. Results. There were no statistically significant differences between the groups in baseline clinical characteristics or type of surgery; prolonged (>24 h) antibiotic prophylaxis was more frequent in the comparison group (42 vs 15.0%; p = 0.08). HAI occurred in 1 of 20 (5.0%) patients in the EMF group and in 3 of 19 (16%) patients in the comparison group. Vascular graft infection and sepsis occurred only in the comparison group – in 2 (10.5%) patients (p = 0.23). There were no deaths. Conclusions. To assess the effect, a randomized trial of sufficient capacity with follow-up after discharge is necessary.