Increased Risk of Wound Complications and Poor Healing following Laparotomy in HIV-Seropositive and AIDS Patients

Abstract

The number of individuals in the UK who are HIV seropositive is increasing as is their presentation with abdominal complications. Poor wound healing following anorectal surgery in HIV-positive patients has been well reported. This study reviews the incidence of wound complications following laparotomy. The hospital records of all HIV-positive patients who underwent laparotomy at a London teaching hospital over a 10-year period were reviewed and compared to an equal number of matched non-HIV patients. Between April 1986 and April 1996, 64 laparotomies were carried out on 53 patients. There was a significantly greater incidence of wound complications (χ² = 12.75, 1 d.f., p = 0.0003) and wound breakdown (χ² = 10.45, 1 d.f., p = 0.012) in the HIV group following laparotomy than in the non-HIV control group.

Prevalence of HIV Status and CD4 Counts in a Surgical Cohort: Their Relationship to Clinical Outcome

“…3 Better outcomes have been noted particularly in HIV-positive patients without any manifestations of AIDS, where the complications were similar to those encountered in the non-infected population. 13,16,17 However, in one these studies, 16 wound healing was deleteriously affected in the HIV-positive group.…”

Effect of CD4+ T-lymphocyte count on hospital outcome of elective general thoracic surgery patients with human immunodeficiency virus

“…During surgery of HIV-infected patients, greater morbidity and poor wound healing were observed during the latter half of the 1990s, and many complications (e.g., postoperative pneumonia) were observed. [6][7][8] reported that, in accordance with the medical literature for the clinical outcomes of HIV-infected and AIDS patients, immune cell counts and HIV-1 RNA counts were associated with postoperative mortality. However, the postoperative decrease in the percentage of CD4-positive T-lymphocytes proved to be an independent predictor of postoperative complications.…”

Case Report:Reduction Mammoplasty in an HIV-Positive Woman

“…12 Davis et al 13 examined the biomechanical tensile strength of incisional scars from patients with HIV and noninfected controls and found the scars of patients with HIV have less tensile strength. 13 This finding does not eliminate elective surgery as an alternative.…”