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In reply

The comments and added information in the letters of Petrosillo et al and Puro et al were much appreciated.

We concur that wound infection rates may be increased in human immunodeficiency virus–positive patients but believe that this is directly related to the immunological status of the patient. For example, Emparan et al¹ noted a significant increase in infections after abdominal surgery when the CD4 count was less than 200 cells/mL. On the other hand, Buehrer et al² reported no significant differences between the wound infection rates of human immunodeficiency virus–positive and human immunodeficiency virus–negative hemophiliacs unless they had progressed to AIDS. Clearly, the patients' immunocompetency is a major factor in postoperative wound infection as we would expect.

Puro et al's recommendation that a tailored preexposure protocol should be on hand for human immunodeficiency virus–positive patients undergoing elective surgery is most sensible. Although we are not familiar with this . . . [Full Text of this Article]

AUTHOR INFORMATION
Samuel E. Wilson, MD; Russell Williams, MD

RELATED ARTICLE

Surgical Site Infections in Patients With Human Immunodeficiency Virus
Nicola Petrosillo, Angelo Pan, Vincenzo Puro, and for the Gruppo HIV e Infezioni Ospedaliere
Arch Surg. 2006;141(6):611-612.
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