The incidence and consequences of early wound infection after internal fixation for trauma in HIV-positive patients

J Bates, Nyengo Mkandawire, W Harrison

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    24 Citations (Scopus)

    Abstract

    We report a prospective single-blind controlled study of the incidence of early wound infection after internal fixation for trauma in 609 patients, of whom 132 were HIV-positive. Wounds were assessed for healing using the ASEPSIS score. There was no significant difference in the rate of infection between HIV-positive and HIV-negative patients undergoing clean surgery (4.2% vs 6%, respectively; p = 0.65). HIV-positive patients did not receive additional antibiotic prophylaxis or antiretroviral therapy as part of their management. The difference in the rate of infection between HIV-positive and HIV-negative patients with an open fracture or other contamination was not significant (33% vs 15%, respectively; p = 0.064). There was no relationship between CD4 count and infection rate. HIV status did not significantly influence the number of secondary surgical procedures (p = 0.183) or the likelihood of developing chronic osteomyelitis (p = 0.131). Although previous contamination from the time of injury was a risk factor for infection in mal- and nonunions, it was not significantly increased in HIV-positive patients (p = 0.144). We conclude that clean implant surgery in HIV-positive patients is safe, with no need for additional prophylaxis.

    Original languageEnglish
    Pages (from-to)1265-1270
    Number of pages6
    JournalJOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME
    Volume94-B
    Issue number9
    DOIs
    Publication statusPublished - Sep 2012

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