Risk factors for surgical wound infection in HIV-positive patients undergoing surgery for orthopaedic trauma.
OBJECTIVE
To identify risk factors associated with surgical wound infection in patients infected with human immunodeficiency virus (HIV) undergoing surgery for orthopaedic trauma.


METHODS
Records of 29 male and 7 female HIV-positive patients aged 18 to 47 years who underwent surgery for orthopaedic trauma were reviewed. Data on HIV-specific variables (HIV clinical classification, CD4+ lymphocyte count) and highly active antiretroviral therapy were retrieved, as were data on wound class, fracture type, surgery type, surgical wound infections, and outcomes. Possible risk factors associated with surgical wound infection were analysed.


RESULTS
The median follow-up period was 27 (range, 19-41) months. Of the 36 patients, 14 (39%) developed surgical wound infections (4 were deep and 10 superficial). 89% and 67% of them were in HIV clinical category B and in CD4+ T-lymphocyte category 3, respectively. 12 of these infections resolved after debridement and prolonged antibiotic treatment, and 2 developed chronic osteomyelitis. Four of the patients had non-union. Surgical wound infections were associated with HIV clinical category B (p<0.001), CD4+ T-lymphocyte category of more than or equal to 2 (p=0.041), and contaminated wounds (p=0.003).


CONCLUSIONS
Identification of risk factors may help minimise morbidity in HIV-positive patients.
Abalo
Anani
A
Department of Orthopaedics, Tokoin Teaching Hospital, Lome, Togo. grabanl@yahoo.fr
Patassi
Akouda
A
James
Yaovi Edem
YE
Walla
Atsi
A
Sangare
Aly
A
Dossim
Assang
A
D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D015153:Blotting, Western; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006678:HIV / Q000276:immunology*; D015483:HIV Antibodies / Q000032:analysis; D006679:HIV Seropositivity / Q000150:complications* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D014037:Togo / Q000453:epidemiology; D014947:Wounds and Injuries / Q000150:complications / Q000601:surgery*; D055815:Young Adult
D015483:HIV Antibodies