Study for wound healing in HIV-infected patients

点击翻译按钮获取中文摘要

The purpose of this study is to establish the criteria of surgical indications for HIV infected patients whose abillity of wound healing is poor in late stage of HIV infection.Experimentaly we made MAIDS using B6 mouse.The breaking strength of a healing skin incision in the MAIDS was decreased one eighth comparing the strength in a control mouse.We tried to establish cell lines of fibroblast from a piece of skin of HIV infected patients who received operation but we could not established cell lines.HIV did not infect cultured normal fibroblasts.clinically we studied delay of wound healing for 3 patients (stage IV) who received repair of indirect inguinal hernia and for 5 patients (stage III : 1, stage IV : 4) who received laparotomy.In every case, it took 2-4 weeks for healing of wound incision without keloid formation.Even if the cell count of CD4 positive cells was less than 100/mul, wounds would heal on condition that HIV infection and HIV-indicator diseases are controllable.According to Montaner's staging system, we propose criteria for surgical indication for HIV-infected patients as follows.For stage I,assessment is made by the usual indications.In stage II,consideration should be given to HIV-related pathogenesis.For stage III as for stage II,curative operations should be performed.For stage IV,primary consideration is given to palliative operations for alleviating symptoms but if the general condition of the patient is good, a curative operation may be performed.