Li Xin, Zhang Qiang, Zhao Changsong, Sun Sheng, Cai Juan
Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China.
Department of Orthopedics, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China. Email:
Zhonghua Yi Xue Za Zhi. 2014 Sep 9;94(33):2589-92.
To observe the healing status of surgical incisions in human immunodeficiency virus (HIV)-positive patients with fractures and explore the factors related with poor wound healing, treatment and preventive measures.
Retrospective analyses were performed for the clinical data of 61 HIV-positive patients with fractures. And the influencing factors, treatment and outcomes of poor wound healing were analyzed.
Among them, the healing status was good (n = 50) and poor (n = 11). And the outcomes included redness (n = 10), oozing (n = 8), split (n = 3), infection (n = 2), hematoma (n = 1), fat liquefaction (n = 2) and delayed healing (n = 2). All healed well after treatment. There was no infection or death during the follow-up period. Compared with HIV-negative patients, it was not statistically significant in wound infection. However, poor healing rates were significantly different (P < 0.05). The risk factors included advanced age, low body mass index, low albumin, low hemoglobin, low total lymphocyte count, low CD4⁺ T lymphocyte count, high HIV infection clinical stage, long operative duration, emergency surgery and incision contamination.
In HIV-positive patients with fractures, the healing of surgical incision is generally good. However few have poor wound healing due to multiple factors. If poor healing is identified early and handled timely and correctly, good healing ensues.
观察人类免疫缺陷病毒(HIV)阳性骨折患者手术切口的愈合情况,探讨影响伤口愈合不良的相关因素、治疗方法及预防措施。
对61例HIV阳性骨折患者的临床资料进行回顾性分析,分析伤口愈合不良的影响因素、治疗方法及结果。
其中,愈合情况良好者50例,愈合不良者11例。愈合不良的结果包括切口发红10例、渗液8例、裂开3例、感染2例、血肿1例、脂肪液化2例及愈合延迟2例。经治疗后均愈合良好。随访期间无感染及死亡病例。与HIV阴性患者相比,伤口感染情况差异无统计学意义,但愈合不良率差异有统计学意义(P<0.05)。危险因素包括高龄、低体重指数、低白蛋白、低血红蛋白、低总淋巴细胞计数、低CD4⁺T淋巴细胞计数、HIV感染临床分期高、手术时间长、急诊手术及切口污染。
HIV阳性骨折患者手术切口愈合情况总体良好,但少数患者因多种因素导致伤口愈合不良。若能早期发现并及时正确处理,可实现良好愈合。