Risk Factors for Surgical Wound Infection in HIV-Positive Patients Undergoing Surgery for Orthopaedic Trauma

Author:

Abalo Anani1,Patassi Akouda1,James Yaovi Edem1,Walla Atsi1,Sangare Aly1,Dossim Assang1

Affiliation:

1. Department of Orthopaedics, Tokoin Teaching Hospital, Lome, Togo

Abstract

Purpose. 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 ≥2 (p=0.041), and contaminated wounds (p=0.003). Conclusion. Identification of risk factors may help minimise morbidity in HIV-positive patients.

Publisher

SAGE Publications

Subject

Surgery

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