       Document 0350
 DOCN  M9610350
 TI    Infection following treatment of mandibular fractures in human
       immunodeficiency virus seropositive patients.
 DT    9601
 AU    Schmidt B; Kearns G; Perrott D; Kaban LB; Department of Oral and
       Maxillofacial Surgery, University of; California, San Francisco
       94143-0440, USA.
 SO    J Oral Maxillofac Surg. 1995 Oct;53(10):1134-9. Unique Identifier :
       AIDSLINE MED/96025029
 AB    PURPOSE: There are little data available on the prevalence of human
       immunodeficiency virus (HIV) disease and its relationship to
       postoperative infection in patients presenting with mandibular
       fractures. This retrospective study assesses these parameters. PATIENTS:
       The study population consisted of 251 patients treated for mandibular
       fractures at San Francisco General Hospital (SFGH) between January 1990
       and December 1993. Group 1 (n = 20) was composed of patients with
       documented HIV infection and group 2 (n = 231) served as controls. The
       groups were comparable with regard to age, sex, etiology, and number and
       types of fractures. RESULTS: HIV prevalence for this population was
       7.9%, and was consistent with previously documented prevalence studies
       in SFGH surgical patients. In the HIV-positive group, 6 of 20 patients
       (30%) developed postoperative infection: 2 soft tissue (10%) and 4
       bone-related (20%). In the control group, 22 of 231 patients (9.5%)
       developed postoperative infections: 16 soft tissue (6.9%) and 6
       bone-related (2.6%). Statistical analysis showed a significant
       difference between the two groups with regard to overall (P = .016) and
       to bone-related (P = .001) infection rates. There was no statistically
       significant difference in soft tissue infections between the two groups
       (P = .953). The rate of postoperative infection was significantly higher
       in those patients (both HIV-positive and controls) who had open
       reduction and internal fixation (ORIF; 25/155; 16%) versus those who had
       closed reduction and maxillomandibular fixation (3/96; 3.1%; P = .003).
       The postoperative infection rate after ORIF was significantly higher in
       the HIV-positive (5/11; 45%) compared with the control group (20/144;
       13.9%; P = .02). CONCLUSIONS: The results of this study indicate that
       the overall rate of postoperative infection after treatment of
       mandibular fractures is significantly higher in HIV-positive than in
       HIV-negative patients. Specifically, the use of ORIF in HIV-positive
       patients represents a significant risk.
 DE    Acquired Immunodeficiency Syndrome  Adult  Case-Control Studies
       Comparative Study  Disease Susceptibility  Female  Fracture Fixation,
       Internal/ADVERSE EFFECTS/INSTRUMENTATION  Human  HIV Seronegativity
       *HIV Seropositivity  Immobilization  Male  Mandibular
       Diseases/MICROBIOLOGY  Mandibular Fractures/*SURGERY/*THERAPY
       Osteomyelitis/MICROBIOLOGY  Prevalence  Retrospective Studies  Risk
       Factors  San Francisco  Soft Tissue Infections  *Surgical Wound
       Infection  *Wound Infection  JOURNAL ARTICLE

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

