[Effect of wound healing of orthopedic surgery in human immunodeficiency virus infected patients with perioperative adjuvant treatments].
OBJECTIVE
To observe the early wound healing of orthopedic surgery in human immunodeficiency virus (HIV) carrier patients treated with optimized auxiliary treatments.


METHODS
During a period of 48 months, according to the inclusion and exclusion criteria plus CD4⁺ T lymphocyte count, the patients scheduled for orthopedic surgery (including HIV positive and negative) were divided into group A (HIV positive, CD4<500/ml) with optimized auxiliary treatments, group B (HIV positive, CD4 ≥ 500/ml) and group C (HIV negative) on prophylactic antibiotic therapy alone. Wound healing of 3 groups were observed postoperatively. The rates of clinical wound infection were compared among 3 groups.


RESULTS
A total of 471 cases (n = 79, HIV+; n = 392, HIV-) were selected due to fresh fracture (n = 544, 77.28%), fracture of spine (n = 57, 12.31%), mal-union (n = 13, 2.76%), aseptic necrosis (n = 15, 3.18%) and osteoarthritis (n = 21, 4.46%). During surgery, early open reduction and plate screw internal fixation (group A, n = 23; group B, n = 21; group C, n = 274); pedicle screw internal fixation (group A, n = 5; group B, n = 6; group C, n = 47); total joint replacement (group A, n = 3; group B, n = 4; group C, n = 8); interlocking intramedullary nail fixation (group A, n = 7; group B, n = 4; group C, n = 35) and other operations (group A, n = 3; group B, n = 3; group C, n = 28). For infections, 2 cases (4.88%) were observed in group A, 3 (5.26%) in group B and 26 (6.63%) in group C. The differences were statistically insignificant.


CONCLUSIONS
Reasonable perioperative adjuvant treatments, including use of antibiotic, nutritional supports, immunomodulators and anti-retroviral drugs, are offered to HIV infected patients undergoing orthopedic surgery. Their risks of postoperative wound infection may be controlled.
Department of Orthopedics, Affiliated Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Sheng
S
Sun
Yaoshen
Y
Zhang
Email: zhangqwte@sina.com.
Qiang
Q
Zhang
Xin
X
Li
Gang
G
Wan
Changsong
C
Zhao
Juan
J
Cai
Zheng
Z
Yuan
D001863:Bone Screws; D018791:CD4 Lymphocyte Count; D050723:Fractures, Bone; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D016268:Internal Fixators; D009985:Orthopedics; D013530:Surgical Wound Infection; D014945:Wound Healing