Surgical Procedures in Patients at Risk of Human Immunodeficiency Virus Infection

Wakeman, Ruth; Johnson, C. D.; Wastell, C

doi:10.1177/014107689008300513

Cited by 28 publications

(6 citation statements)

References 8 publications

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“…It has been previously described that anorectal surgery in patients with HIV infection and AIDS, particularly those severely immunodeficient in CDC category B and C, is associated with a high incidence of delayed wound healing [4, 5, 6, 7, 8, 9, 10, 11, 12]. It has been found in some studies [4, 7]that patients with poor healing had a lower pre-operative white cell count compared to those that healed, and other more recent studies [11, 12]have found a correlation between poor wound healing and pre-operative CD4 count.…”

Section: Introductionmentioning

confidence: 99%

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

Davis

Corless²,

Gazzard³

et al. 1999

Dig Surg

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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.

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Section: Introductionmentioning

confidence: 99%

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

Davis

Corless²,

Gazzard³

et al. 1999

Dig Surg

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“…Therefore, HIV infection was assumed not to impair wound healing after surgery, at least during the asymptomatic phase of infection. 11) In contrast, AIDS was significant in delaying wound healing of hemorrhoidectomy and such infection might be correlated statistically with delayed healing. The risk of hemorrhoidectomy wound complications could be predicted in HIV-positive patients based on the Centers for Disease Control and Prevention HIVinfection status, CD4 counts, and Karnofsky performance status score.…”

Section: Discussionmentioning

confidence: 97%

Aneurysmal Subarachnoid Hemorrhage in a Patient With Human Immunodeficiency Virus Type 1 Infection-Case Report-

Miyamoto

Hara

Tabei

et al. 2006

Neurol. Med. Chir.(Tokyo)

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A 54-year-old human immunodeficiency virus type 1 (HIV-1)-infected homosexual Japanese male was found to have collapsed in his bathroom and was brought to our facility with diminished level of consciousness. Computed tomography showed subarachnoid hemorrhage (SAH). He was severely dehydrated with unstable general status that deterred us from performing emergent surgery. Cerebral angiography performed on the 18th hospital day revealed bilateral distal anterior cerebral artery aneurysms. Clipping of these aneurysms was performed on the 30th hospital day and no postoperative complications were experienced. The scalp wound showed no delayed healing, whereas the tracheostomy wound showed repeated wound dehiscence and delayed healing. Postoperative highly active antiretroviral therapy with antibiotic treatment gradually improved his general and immunological conditions. The patient was finally discharged as independent with mild muscle weakness in the bilateral lower extremities. HIV-1 infection should not be the guiding factor in the decision to aggressively treat concomitant aneurysmal disease. Clipping of cerebral aneurysms with full craniotomy or endovascular obliteration should be considered even in HIV-1-infected patients with SAH.

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“…In vitro CD4‐T‐lymphocyte helper cells secrete numerous cytokines (including transforming growth factor‐β and interleukin 2), promoting cell‐to‐cell adhesion and deposition of fibronectin and leading to enhanced wound healing 9 . Several medical reports attempted to correlate the severity of HIV‐induced immunocompromise, as determined by lowered CD4 counts and diminished cytokine production, to postsurgical wound healing 10‐15 . We were unable to identify any otolaryngologic studies on this topic.…”

Section: Discussionmentioning

confidence: 99%

“…9 Several medical reports attempted to correlate the severity of HIVinduced immunocompromise, as determined by lowered CD4 counts and diminished cytokine production, to postsurgical wound healing. [10][11][12][13][14][15] We were unable to identify any otolaryngologic studies on this topic.…”

Section: Discussionmentioning

confidence: 99%

Otologic Surgery in Patients with HIV‐1 and AIDS

Kohan

Giacchi

1999

Otolaryngol.--head neck surg.

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Otologic disease in patients infected with HIV occurs frequently and usually represents rhinologic disease and associated eustachian tube dysfunction rather than manifestations of HIV infection. As in all patients, the decision to operate on an HIV-infected individual who would benefit from major otologic surgery is a balance between the risks of the procedure and the possible benefits to the patient. Many concerns regarding wound infection and healing have been raised. The objective of this study is to evaluate the outcome of otologic procedures in this population. The charts of 9 men and 4 women were reviewed. Seven patients (54%) met the Centers for Disease Control and Prevention criteria for AIDS. Patients with chronic otitis media (46%) underwent tympanomastoidectomies, and the cases of acute mastoiditis (31%) were managed with simple mastoidectomies. Other procedures included repair of cerebrospinal fluid leak (15%) and stapedectomy (8%). Two patients had early complications and died during their hospitalizations. Three patients had prolonged hospital courses requiring long-term antibiotics. These 5 patients underwent urgent procedures and were severely immunocompromised. Of the remaining 8 patients only 2 had AIDS, and all had an uncomplicated postoperative course. Six of these patients were followed up for more than 1 year, and only 2 developed subsequent otologic disease.

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Surgical Procedures in Patients at Risk of Human Immunodeficiency Virus Infection

Cited by 28 publications

References 8 publications

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

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

Aneurysmal Subarachnoid Hemorrhage in a Patient With Human Immunodeficiency Virus Type 1 Infection-Case Report-

Otologic Surgery in Patients with HIV‐1 and AIDS

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