Hand injuries secondary to subcutaneous illicit drug injections

We present a retrospective analysis of 32 patients admitted over a 5-year period to a metropolitan regional trauma center with recently induced subcutaneous ("skin pop") illicit drug injectional injuries involving the hand. Cocaine derivatives were the most frequently reported illicit drug...

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Bibliographic Details
Published in:	Annals of plastic surgery Vol. 34; no. 1; p. 27
Main Authors:	Thomas, 3rd, W O, Almand, J D, Stark, G B, Parry, S W, Rodning, C B
Format:	Journal Article
Language:	English
Published:	United States 01-01-1995
Subjects:	Abscess - drug therapy Abscess - etiology Adolescent Adult Anti-Bacterial Agents - therapeutic use Cocaine - administration & dosage Female Hand Heroin - administration & dosage Humans Injections - adverse effects Male Middle Aged
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Summary:	We present a retrospective analysis of 32 patients admitted over a 5-year period to a metropolitan regional trauma center with recently induced subcutaneous ("skin pop") illicit drug injectional injuries involving the hand. Cocaine derivatives were the most frequently reported illicit drug used (75%). All patients had local disease manifested by subcutaneous abscess formation, and several had regional disease (cellulitis, lymphangitis, or lymphadenopathy), but only one patient had systemic illness. Microbiological analysis revealed endogenous integumentary and oral flora sensitive to oral preparations of several antibiotic medications including cephalosporins. Primary therapy included intravenous administration of antibiotic medications in all instances and simple incision and drainage under local anesthesia in 26 patients (81%). Six patients (19%) required more radical operative therapy. All patients were hospitalized and recovered without sequelae, with preservation of hand function after follow-up evaluation, which ranged from weeks to months, except for 1 patient who required digital amputation because of necrosis. Although the issue of compliance in terms of wound and general medical care for this patient population is problematic, analysis of the data suggested that patients with illicit drug injectional injuries of the hand confined to subcutaneous regions could be effectively and safely managed in outpatient settings by simple wound care and orally administered cephalosporin medications.
ISSN:	0148-7043
DOI:	10.1097/00000637-199501000-00006