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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The effect of HIV on early wound healing in open fractures treated with internal and external fixation
Journal of Bone and Joint Surgery - Series B, Volume 93 B, No. 5, Year 2011
Notification
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Description
There are 33 million people worldwide currently infected with human immunodeficiency virus (HIV). This complex disease affects many of the processes involved in wound and fracture healing, and there is little evidence available to guide the management of open fractures in these patients. Fears of acute and delayed infection often inhibit the use of fixation, which may be the most effective way of achieving union. This study compared fixation of open fractures in HIV-positive and -negative patients in South Africa, a country with very high rates of both HIV and high-energy trauma. A total of 133 patients (33 HIV-positive) with 135 open fractures fulfilled the inclusion criteria. This cohort is three times larger than in any similar previously published study. The results suggest that HIV is not a contraindication to internal or external fixation of open fractures in this population, as HIV is not a significant risk factor for acute wound/implant infection. However, subgroup analysis of grade I open fractures in patients with advanced HIV and a low CD4 count (< 350) showed an increased risk of infection; we suggest that grade I open fractures in patients with advanced HIV should be treated by early debridement followed by fixation at an appropriate time. ©2011 British Editorial Society of Bone and Joint Surgery.
Authors & Co-Authors
Aird, James J.
South Africa, Empangeni
Ngwelezana Hospital
United Kingdom, Bristol
Frenchay Hospital
Noor, Saqib
South Africa, Empangeni
Ngwelezana Hospital
United Kingdom, Birmingham
The Royal Orthopaedic Hospital Nhs Foundation Trust
Lavy, Chris B.D.
South Africa, Empangeni
Ngwelezana Hospital
United Kingdom, Oxford
Nuffield Orthopaedic Centre
Rollinson, Paul D.
South Africa, Empangeni
Ngwelezana Hospital
Statistics
Citations: 25
Authors: 4
Affiliations: 4
Identifiers
Doi:
10.1302/0301-620X.93B5.26081
ISSN:
0301620X
Research Areas
Health System And Policy
Infectious Diseases
Violence And Injury
Study Design
Cross Sectional Study
Cohort Study
Study Locations
South Africa