Conflicts in the treatment of chronic ulcers in drug addicts--case series and discussion.
Vascular access in intravenous drug abusers may become compromised by the repeated injection of toxic substances. In such circumstances abusers are driven by their addiction to seek alternative routes of drug delivery. We report a series of individuals with chronic ulcers, which were cultivated and maintained for the administration of heroin. We advise that practitioners should be wary of granulation tissue being promoted in this way and suggest that the patients' desire for wound healing may be overridden by their addiction and that successful treatment of these wounds is reliant upon cessation of drug abuse and patient compliance. In our experience this is most easily achieved in a multidisciplinary environment.
Williams
A M
AM
Plastic and Reconstructive Surgery Department, Pinderfields General Hospital, Aberford Road, Wakefield WF1 4DG, UK. amw29@doctors.org.uk
Southern
S J
SJ
D000328:Adult; D002908:Chronic Disease; D006097:Granulation Tissue / Q000473:pathology; D006556:Heroin Dependence / Q000150:complications* / Q000523:psychology; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D010349:Patient Compliance; D012883:Skin Ulcer / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology; D014945:Wound Healing