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1996-01-30
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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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).