We compared early post-operative rates of wound
infection in HIV-positive and -negative patients presenting with open
tibial fractures managed with surgical fixation. The wounds of 84 patients (85 fractures), 28 of whom were HIV
positive and 56 were HIV negative, were assessed for signs of infection
using the ASEPIS wound score. There were 19 women and 65 men with
a mean age of 34.8 years. A total of 57 fractures (17 HIV-positive, 40
HIV-negative) treated with external fixation were also assessed using
the Checkett score for pin-site infection. The remaining 28 fractures
were treated with internal fixation. No significant difference in
early post-operative wound infection between the two groups of patients
was found (10.7% (n = 3) vs 19.6% (n = 11); relative
risk (RR) 0.55 (95% confidence interval (CI) 0.17 to 1.8); p = 0.32).
There was also no significant difference in pin-site infection rates
(17.6% (n = 3) vs 12.5% (n = 5); RR 1.62 (95% CI
0.44 to 6.07); p = 0.47). The study does not support the hypothesis that HIV significantly
increases the rate of early wound or pin-site infection in open
tibial fractures. We would therefore suggest that a patient’s HIV
status should not alter the management of open tibial fractures
in patients who have a CD4 count >
350 cells/μl. Cite this article:
