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kompleksnosti liječenja kao i značajnosti multidisciplinarnog pristupa u liječenju ove grupe
pacijenata. Hirurško liječenje je bitan element u zaustavljanju infekcije i njenom izlječenju, kao i
rekonstrukciji većih defekata kože, a poseban klinički izazov je precizno razlikovanje infekcijskih
komplikacija koje mogu imati vrlo težak tok.

Abstract

Introduction: Infections on the extremities are a common occurrence in psychoactive substance addicts who use the drug
intravenously. A significant risk of infection is present due to non-sterile conditions and/or incorrect injection of substances.
Other contributing factors in this group of patients are comorbidities, impaired body defense mechanisms, harmful
habits, and a lifestyle inconsistent with recommendations for a healthy life. Surgical treatment is essential in solving
these complications, but also in repairing skin and soft tissue defects. In the professional literature, in both psychiatric
and surgical specialties, few studies dealt with infections as complications in psychoactive substance addicts and surgical
procedures in their treatment.

Material and method: A retrospective analysis of infections as a complication on the extremities in addicts of psychoactive
substances hospitalized in one center for two years was performed.

Results: A group of 24 patients was analyzed. All patients were long-term intravenous drug users. The lower extremity was
more often affected by infections (which were registered in 14 or 58.33% of patients), while changes on the hands were
registered in 10 or 41.67% of patients. Affected limb parts were: the upper arm (4 or 16.67%), forearm (7 or 29.17%), arm (1
or 4.17%), the upper part of the leg (5 or 20.83%), the lower part of the leg (6 or 25%) and foot (3 or 12.5% of addicts). Acute
manifestations of infections were: abscesses (8 or 33.33%), phlegmon (5 or 20.83%), cellulitis (2 or 2.24%), tissue necrosis (2
or 2.24%), necrotic fasciitis ( 3 or 12.5%), lymphadenitis (4 or 16.67%) and phlebitis (4 or 16.67% of addicts). All patients were
treated surgically during hospitalization; initial surgical treatment included: incisions, debridement, necrectomy, application
of negative pressure, sequestrectomy, instillation, and amputation; 13 (54.17%) patients were treated using reconstructive
surgical procedures.

Conclusion: Surgical treatment of infectious complications in intravenous drug users is necessary in cases of a developed
clinical picture and the presence of a systemic infectious response. Surgical treatment is an essential element in the
prevention and treatment of infection and the reconstruction of major skin defects.

Keywords: infection, complications on the extremities, addiction to psychoactive substances, intravenous drug use,
wounds, surgery

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24 DOI: 10.5937/Galmed2307019V