LAUSR

OBJECTIVE A lack of studies analyze risk factors associated with SSI in HIV-positive patients with trauma undergoing orthopedic surgery. We questioned (1) what is the proportion with SSI in HIV positive patients receiving open reduction and internal fixation (ORIF) of traumatic limb fractures; (2) what are the independent risk factors for SSI of HIV positive patients with traumatic limb fractures who received ORIF. METHODS A retrospective study was performed in our institution from May 2011 to December 2019. A total of 246 patients were enrolled. Data of HIV positive adult patients with traumatic limb fractures treated by ORIF were extracted from the electronic medical records, including the demographic information, characteristics of fractures, treatment-related variables and indexes of laboratory examination. Multivariable logistic regression was used to identify independent predictors of surgical site infection. RESULTS A total of 26 patients developed SSI in this study, the overall proportion was 10.6% (95% CI=7.2%-15.3%). Amongst them, 18 cases (7.3%) suffered from superficial SSI and 8 cases (3.3%) had the deep SSI.Independent predictors of SSI identified by multivariable logistic regression analysis were CD4+ T-lymphocyte count (adjusted odds ratio per 100/µL increase=0.55; 95% CI=0.37-0.81; p=0.002) and albumin (adjusted odds ratio per 5 g/l increase=0.50; 95% CI=0.30-0.81; p=0.003). CONCLUSION We recommend that orthopedic surgeons assess immunosuppression and nutritional status of HIV positive patients rigorously and optimize the perioperative strategy of supplementary to reduce the risk of SSI.