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LI Xin,ZHANG Qiang,ZHAO Changsong.A comparative study on wound healing of spinal incision between HIV infected patients and non HIV infected patients[J].Chinese Journal of Spine and Spinal Cord,2017,(3):248-253. |
A comparative study on wound healing of spinal incision between HIV infected patients and non HIV infected patients |
Received:October 30, 2016 Revised:February 05, 2017 |
English Keywords:Spinal incision Acquired immune deficiency syndrome Human immunodeficiency virus Wound healing Infection |
Fund:首都临床特色应用研究(No.Z131107002213063);院内科研基金“育苗计划”项目(DTYM201606);北京市卫生和计划生育委员会卫生科技成果和适宜技术推广项目(No.TG-2015-05) |
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English Abstract: |
【Abstract】 Objectives: To observe and compare the wound healing of spinal incision between human immunodeficiency virus(HIV) infected patients and non HIV infected patients, and to explore the risk factors of poor wound healing in HIV infected patients. Methods: From June 2011 to June 2015, 40 HIV infected patients in our hospital with spinal disorders were enrolled. In the same period, 40 patients with non HIV infected patients were selected as control group matched with the gender, age and operation method. The poor wound healings between HIV infected patients and non HIV infected patients were compared, such as swelling, exudation, rupture, infection, hematoma, fat liquefaction, etc. Age, gender, BMI, albumin, HIV infection clinical stage, CD4+ T cell counts, surgical site, surgical approach, surgical segment, internal fixation, fusion, minimally invasive surgery, operation time and blood loss were compared between poor wound healing and good healing in HIV infected patients. Results: 32 HIV infected patients healed well, while 8 HIV infected patients had poor healing, including 8 incisions of swelling, 5 incisions of exudation, 1 incision of rupture, 1 incision of fat liquefaction, 1 case of delayed healing, 2 incisions of superficial infection, including 1 case of staphylococcus aureus and the other negative. In control group, 39 patients had good healing, while 1 patient had poor wound healing, including 1 superficial infection with negative bacterial culture. There was no significant difference in age, gender, BMI, albumin, HIV infection stage, CD4+ T cell counts, surgical site, surgical approach, surgical segment, internal fixation, fusion, minimally invasive surgery, operation time or blood loss between HIV infected and non HIV infected patients(P>0.05). There was no significant difference in the rate of surgical site infection between HIV infected and HIV infected patients(P>0.05). However, difference in the rate of poor healing was significant(P<0.05). All patients with poor wound healing healed well after timely treatment, without late infection, sepsis or death. CD4+ T cell counts, HIV infection clinical stage, BMI and serum albumin were significantly different between good healings and poor healings in HIV infected patients(P<0.05). Conclusions: HIV infected patients are more likely to have poor wound healing than non HIV infected patients, without significant difference in surgical site infection. HIV infected patients with HIV infection stage C, CD4+ T cell counts less than 200 cells/μl, low BMI and albumin should be paid attention. |
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