[Injection site abscesses in intravenous drug users. Frequency of associated complications related to localisation].
BACKGROUND
Skin and soft tissue infections are the most frequent cause of hospital admissions among intravenous drug users. Associated complications include septic arthritis, septic thrombosis and embolisation, peripheral ischaemia due to intra-arterial injections, venous and arterial pseudoaneurysms, local destruction of adjacent structures, and necrotising fasciitis.


METHODS
We conducted a retrospective review of the associated complications of 85 patients with 130 abscesses treated during 108 hospital stays.


RESULTS
The majority of abscesses (55%) were located on the lower extremities, where the complication rate following injections was significantly higher than in other parts of the body (12/71 vs 0/55, P=0.0005). Patients with abscesses on the lower extremities had significantly longer hospital stay than those with abscesses on other localisations (8.5 days vs 4.2 days, P=0.0005) and therefore were more expensive to treat.


CONCLUSIONS
Surgeons treating abscesses caused by intravenous drug use must be aware of the higher rate of associated complications after injection in the lower extremities. Prevention in drug addiction programs could reduce complications and costs related to drug use by avoiding injection sites on the lower extremities.
Pfefferkorn
U
U
Departement Chirurgie, Universitätsspital Basel, Schweiz. upfefferkorn@uhbs.ch
Viehl
C T
CT
Bassetti
S
S
Wolff
T
T
Oertli
D
D
D000038:Abscess / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D005121:Extremities; D005260:Female; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000601:surgery; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000601:surgery*; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000601:surgery; D014946:Wound Infection / Q000601:surgery*