High Rates of Abscesses & Chronic Wounds in Community-Recruited Injection Drug Users & Associated Risk Factors

OBJECTIVES:

Abscesses and chronic wounds are common among injection drug users (IDUs) though chronic wounds have been understudied. We assessed the risk factors associated with both acute and chronic wounds within a community-based population of IDUs frequenting the Baltimore City Needle Exchange Program (BNEP).

METHODS:

We performed a cross-sectional study of BNEP clients aged 18 years or more who completed an in-person survey regarding active or prior wounds including abscesses (duration <8 weeks) and chronic wounds (duration ≥8 weeks), injection practices, and skin care. Factors associated with wounds were analyzed using univariate and multivariate logistic regressions.

RESULTS:

Of the 152 participants, 63.2% were men, 49.3% were white, 44.7% were African American, 34.9% had any type of current wound, 17.8% had an active abscess, and 19.7% had a current chronic wound. Abscesses were more common in women and those reporting skin-popping. In a multivariate model, risk factors for an abscess included injecting with a family member/partner. In a multivariable analysis of current chronic wounds, cleaning skin with alcohol before injection was protective.

CONCLUSIONS:

Abscesses and chronic wounds were prevalent among a sample of IDUs in Baltimore. Abscesses were associated with injection practices, and chronic wounds seemed linked to varying skin and tool cleaning practices. There is a pressing need for wound-related education and treatment efforts among IDUs who are at greatest risk for skin-related morbidity.

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By:  Smith ME1, Robinowitz N, Chaulk P, Johnson KE.

• 1From the Department of Medicine (MES, KEJ), Division of Infectious Diseases, Johns Hopkins Medical Institutions, Baltimore, MD; and Baltimore City Health Department (NR, PC), Baltimore, MD. 

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