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Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management

Sanchez, Daniela P., Tookes, Hansel, Pastar, Irena, Lev-Tov, Hadar·2021·Advances in Wound Care
DOI 10.1089/wound.2020.1243PMC PMC8312019
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Abstract

Significance: Opioid use disorder and transition to injection drug use (IDU) are an urgent, nationwide public health crisis. Wounds and skin and soft tissue infections (SSTIs) are common complications of IDU that disproportionately affect people who inject drugs (PWID) and are a major source of morbidity and mortality for this population. Critical Issues: Injections in a nonsterile environment and reusing or sharing needles facilitates bacterial inoculation, with subsequent risk of serious complications such as sepsis, gangrene, amputation, and death. PWID are susceptible to infections with a wide spectrum of organisms beyond common culprits of SSTI, including Clostridium and Bacillus spp., as well as Candida . Recent Advances: Syringe services programs (SSPs) are cost-effective and successful in reducing harms associated with IDU. SSPs provide new equipment to PWID and aid in discarding used equipment. SSPs aim to reduce the risks of unhygienic injecting practices, which are associated with transmission of infections and blood-borne pathogens. Future Directions: Concurrently run SSPs and wound care clinics are uniquely positioned to facilitate care to PWID. Providing new, sterile equipment as well as early wound care intervention can reduce morbidity and mortality as well as health care expenditures by reducing the number of SSTI and injection-related wounds that require hospital admission. Establishment of wound care clinics as part of an SSP represents an untapped potential to reduce harm.

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Figures

Daniela P. Sanchez, BS
Daniela P. Sanchez, BSCC BY-NC · PubMed Central
Figure 1. IDU-related lower extremity wound. IDU, injection drug use.
Figure 1. IDU-related lower extremity wound. IDU, injection drug use.CC BY-NC · PubMed Central
Figure 2. Common etiologies of wounds and SSTIs in PWID. PWID, people who inject drugs; SSTIs, skin and soft tissue infections.
Figure 2. Common etiologies of wounds and SSTIs in PWID. PWID, people who inject drugs; SSTIs, skin and soft tissue infections.CC BY-NC · PubMed Central
Figure 3. Relationship between combined SSPs and early wound intervention with health outcomes of PWID. SSPs, syringe services programs.
Figure 3. Relationship between combined SSPs and early wound intervention with health outcomes of PWID. SSPs, syringe services programs.CC BY-NC · PubMed Central
Figure 4. Best practice recommendations for SSP for primary and secondary prevention of wounds and SSTIs in PWID.
Figure 4. Best practice recommendations for SSP for primary and secondary prevention of wounds and SSTIs in PWID.CC BY-NC · PubMed Central

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Citations

Cites

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Metadata

Authors
Sanchez, D. P., Tookes, H., Pastar, I., & Lev-Tov, H.
Venue
Advances in Wound Care
Publisher
SAGE Publications
Published
2021-07-23
Volume
10
Issue
10
Pages
571-582
ISSN
  • 2162-1918
  • 2162-1934
DOI
10.1089/wound.2020.1243
PMC
PMC8312019
Cited by
48
References
9
Language
en
Licence

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Sanchez, D. P., Tookes, H., Pastar, I., & Lev-Tov, H. (2021). Wounds and Skin and Soft Tissue Infections in People Who Inject Drugs and the Utility of Syringe Service Programs in Their Management. Advances in Wound Care. https://doi.org/10.1089/wound.2020.1243