Infection following treatment of mandibular fractures in human immunodeficiency virus seropositive patients

Brian Schmidt, Gerard Kearns, David Perrott, Leonard B. Kaban

Research output: Contribution to journalArticle

Abstract

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 post-operative 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.

Original languageEnglish (US)
Pages (from-to)1134-1139
Number of pages6
JournalJournal of Oral and Maxillofacial Surgery
Volume53
Issue number10
DOIs
StatePublished - 1995

Fingerprint

Mandibular Fractures
HIV
Infection
Soft Tissue Infections
Therapeutics
San Francisco
Virus Diseases
Bone and Bones
General Hospitals
Jaw Fixation Techniques
Control Groups
Population
Retrospective Studies
Cross-Sectional Studies

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Surgery
  • Oral Surgery
  • Dentistry(all)

Cite this

Infection following treatment of mandibular fractures in human immunodeficiency virus seropositive patients. / Schmidt, Brian; Kearns, Gerard; Perrott, David; Kaban, Leonard B.

In: Journal of Oral and Maxillofacial Surgery, Vol. 53, No. 10, 1995, p. 1134-1139.

Research output: Contribution to journalArticle

@article{3486d519b8bf4248b35f3fca1db4c2cd,
title = "Infection following treatment of mandibular fractures in human immunodeficiency virus seropositive patients",
abstract = "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 post-operative 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.",
author = "Brian Schmidt and Gerard Kearns and David Perrott and Kaban, {Leonard B.}",
year = "1995",
doi = "10.1016/0278-2391(95)90618-5",
language = "English (US)",
volume = "53",
pages = "1134--1139",
journal = "Journal of Oral and Maxillofacial Surgery",
issn = "0278-2391",
publisher = "W.B. Saunders Ltd",
number = "10",

}

TY - JOUR

T1 - Infection following treatment of mandibular fractures in human immunodeficiency virus seropositive patients

AU - Schmidt, Brian

AU - Kearns, Gerard

AU - Perrott, David

AU - Kaban, Leonard B.

PY - 1995

Y1 - 1995

N2 - 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 post-operative 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.

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 post-operative 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.

UR - http://www.scopus.com/inward/record.url?scp=0029100537&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0029100537&partnerID=8YFLogxK

U2 - 10.1016/0278-2391(95)90618-5

DO - 10.1016/0278-2391(95)90618-5

M3 - Article

C2 - 7562164

AN - SCOPUS:0029100537

VL - 53

SP - 1134

EP - 1139

JO - Journal of Oral and Maxillofacial Surgery

JF - Journal of Oral and Maxillofacial Surgery

SN - 0278-2391

IS - 10

ER -