title: A well vascularised muscle flap--drug user's dream.
abstract: It is estimated that worldwide, 16 million people, aged 15-64 years inject illicit drugs regularly. When peripheral venous access becomes obliterated, drug users start injecting into the subdermal area of the skin - "skin popping". When this area ulcerates, the well vascularised granulation tissue called a "shooter's patch" is maintained as a portal for continuing injection. These "shooter's patches" are usually on the limbs, but have been reported on the breast and the penis. We present a case of a reconstructive muscle flap being used in an unforeseen manner as a shooters patch. Surgeons rely on muscle flaps to provide a robust reconstructive option, but we have learnt that drug users value them for their rich vascularity and high absorption.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wexham Park Hospital, Berkshire, United Kingdom. drsriiyer@hotmail.com
authors.forename: Srinivasan
authors.initials: S
authors.lastname: Iyer
authors.forename: Amit
authors.initials: A
authors.lastname: Pabari
authors.forename: Christopher T
authors.initials: CT
authors.lastname: Khoo
mesh_terms: D055030:Drug Users; D005500:Follow-Up Studies; D006801:Humans; D007717:Knee; D007871:Leg Ulcer / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000098:blood supply / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013524:Surgical Flaps / Q000098:blood supply*; D014945:Wound Healing