Document 0047
 DOCN  M9610047
 TI    Penetrating trauma and emergency surgery in patients with AIDS.
 DT    9601
 AU    Carrillo EH; Carrillo LE; Byers PM; Ginzburg E; Martin L; Department of
       Surgery, University of Miami School of Medicine,; Florida, USA.
 SO    Am J Surg. 1995 Oct;170(4):341-4. Unique Identifier : AIDSLINE
       MED/96013294
 AB    BACKGROUND: Several recent publications have suggested that emergency
       surgery in patients with acquired immunodeficiency syndrome (AIDS) is
       associated with extremely high morbidity and mortality. PATIENTS AND
       METHODS: We reviewed the records of 21 patients with AIDS at the
       University of Miami/Jackson Memorial Medical Center in Miami, Florida,
       who underwent 24 emergency operations after sustaining penetrating
       trauma RESULTS: Nineteen patients (90%) presented with gunshot wounds
       and 2 (10%) presented with stab wounds. Two patients underwent multiple
       surgical procedures to control hemorrhage from a complex liver injury
       and to drain a retained hemothorax, respectively. After surgery,
       patients were managed according to standard protocols, the same as those
       for non-AIDS patients. Wound infection was present in 4 patients (19%),
       and occurred only in patients with < 100 CD4+ cells/microL. Fifty-seven
       percent of patients had no prior knowledge of having AIDS or being
       seropositive for the human immunodeficiency virus. One patient died
       after surgery and 18 patients (86%) were still alive 6 months after
       discharge. CONCLUSIONS: As the AIDS epidemic grows, general surgeons
       will be treating an increasing number of these patients. A low morbidity
       and mortality can be obtained with standard surgical care and
       techniques. Complications are not uncommon and should be treated as in
       any other surgical patient, unless it is a terminal condition or that
       posture runs against the patient's stated views or advance directives.
 DE    Acquired Immunodeficiency Syndrome/*COMPLICATIONS  Adult  *Emergencies
       Female  Human  Male  Retrospective Studies  *Surgery, Operative  Trauma
       Severity Indices  Wounds, Penetrating/*COMPLICATIONS/*SURGERY  JOURNAL
       ARTICLE

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