| To compare surgical incision healing after hip replacement between HIV positive and HIV negative patients, and to explore the clinical significance in inflammatory markers of early changes in HIV-infected patients after operation. Methods Thirty-six HIV-infected patients (HIV positive group) treated with hip replacement in our hospital from November 2010 to June 2018 were included in this study. A total of 36 HIV-negative patients (HIV negative group) undergoing hip replacement at the same time were included as control group. The incision healing in HIV positive and HIV negative groups and the CD4+ T cell count grade of HIV positive patients were recorded. Incidence rate of poor healing of the incision (swelling, exudation, fat liquefaction, rupture, suppuration, etc.) between 2 groups were compared. The differences in early inflammatory markers (white blood cell count, ESR, CRP) were compared between patients with poor incision healing and patients with good incision healing in HIV positive group. Results In HIV positive group, 28 cases had good incision healing and 8 cases had poor incision healing. In HIV negative group, 34 cases had good incision healing and 2 cases had poor incision healing. There was no significant difference in infection rate of surgical site between HIV positive group and HIV negative group (P＞0.05), but there were significant differences in the rate of poor incision healing (P＜0.05). All patients with poor incision healing were eventually healed after timely treatment. No delayed infection, sepsis and death were observed during follow-up. White blood cell count and CRP levels of patients with poor incision healing were higher than those of patients with good incision healing on Day 3, Day 5 and Day 7 after operation, with statistically significant difference (P＜0.05), while ESR on Day 5 after operation was higher than that of patients with good incision healing, with statistically significant difference (P＜0.05) in HIV positive group. There was no significant difference in the number of patients with good incision healing and poor incision healing in HIV positive patients with CD4+ T cell count grade 1 and 2 (P＞0.05). Conclusions By reasonable preoperative evaluation and appropriate perioperative treatment, hip replacement in HIV positive patients can achieve satisfactory clinical efficacy. Postoperative white blood cell count and CRP are indicative of early judgment of incision infection. Treatment should be strengthened for patients with poor incision healing and continuous increase of white blood cell count and CRP levels. |