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A Journal on Physiopathology and Therapy of Chronic Cutaneous Ulcers
Official Journal of the Italian Association for Cutaneous Ulcers
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Acta Vulnologica 2014 December;12(4):193-8
language: English, Italian
An infected wound secondary to subcutaneous heroin injection: self-management in wound care. Case report
Acquaro J., Sales P., Bignamini E.
Addictions Department, TO2 Local Health Unit Turin, Italy
Substance abuse is a major public health problem worldwide. Skin and soft-tissue infections are common complications of injection-drug use and can be caused by adulterants, solutions, difficulty obtaining venous access, and non-sterile injection practices. A 44-year-old man with a 20-year history of intravenous heroin use and currently under methadone maintenance therapy presented because of a skin wound on the left forearm that had arisen about 2 months earlier. He reported having injected heroin subcutaneously because of repeated difficulty obtaining venous access. The wound was approximately 3 mm deep and extended 6 cm in mediolateral and 9 cm in craniocaudal direction, with undermining and a fistulous tract opening at 7 o’clock. The wound was treated with biweekly dressing changes, one performed at the outpatient clinic and the other by the patient at home until complete wound healing. On their first visit to our services, patients are routinely engaged in health education interventions in harm reduction and training in wound self-care and dressing application. Session frequency and choice of topics are negotiated between nurse and patient on the basis of goal-oriented management. Patient empowerment and planned health education are essential tools in patient-centered interventions to improve wound care and quality of life.