Early surgical site infection after Orthopaedic implant surgery in HIV – positive patients at Kenyatta National Hospital.

Abstract

Introduction

ABSTRACT

Surgical Site Infection (SSI) is a disaster both for the patient and the surgeon. SSI related to orthopedic procedures can be associated with serious morbidity, mortality and increased resource utilization. SSI in HIV positive patients post orthopedic implant surgery is an area which is incomprehensively studied. This study seeks to fill in this gap.

Methods

This was a prospective case controlled study carried out over a period of six months at Kenyatta National Hospital. Purposive sampling was applied to select patients admitted for orthopedic implant surgery. Data was collected using a standardized and pretested tool to collect variables such as socio-demographic, HIV status, type of surgery and infection occurrence (SSI). Blood was collected for CD4 count (the HIV positive patients). Data was keyed into Epi Info and exported to SPSS 17.0 for analysis. Measures of central tendency were calculated and bivariate analysis using Fishers exact test. A multivariate analysis using Mantel Haenszel odds ratio to give a weighted average of the odds ratios was also carried out. Results were presented inform of tables, charts and graphs.

Results

A total of 154 respondents participated in this study. Forty six (30%) were HIV positive (cases) and one hundred and twenty one (70%) were HIV negative (controls). HIV positive state didn’t increase the risk of early surgical site infection (OR=0.611, 95%CI=0.0207, 1.798). There was no association between surgical procedure and implant to the likelihood of having early surgical site infection (p value 0.05, 0.33 and 0.74 respectively).

Conclusion and recommendation

HIV status, CD4 count, surgical procedure and implant used were not shown to have any association with prevalence of early surgical site wound infection. A larger prospective study with a longer duration needs to be carried out to reveal a possible correlation between the influences of these variables on surgical site infection.