heroin and Cicatrix

Nested graft is a surgical technique that allows to manage difficult-to-treat medical conditions such as chronic cutaneous ulcers, thanks to the high efficacy it has in reverting the fibroblasts senescence. Because of its peculiar regenerative property, nested graft is a surgical technique suitable also for the treatment of cutaneous ulcers developing on fibrotic scar tissue.. We reported the case of a 45-year-old man, drug-addict, with a large ulcer on the back of the right forearm in the context of scar fibrotic tissue. This lesion resulted from a previous heroin extravasation treated with a dermo-epidermal skin graft, that was accidentally scratched away by mechanical trauma. After several therapeutic failures with topical medications, we decided to treat the ulcer performing a skin graft using the nested graft technique. No adverse events were reported by the patient during or after the surgery. At the clinical evaluation performed three years later the wound was completely healed.. Nested graft represents a safe and easy-to-use technique that can be successfully used to treat ulcers on scar tissue, ensuring the achievement and the long-term maintenance of optimal resistance and aesthetic results.

Topics: Chronic Disease; Cicatrix; Heroin; Humans; Male; Middle Aged; Pressure Ulcer; Skin Transplantation; Substance-Related Disorders; Wounds and Injuries

Tissue sections from injection marks from 30 drug addicts and sections from endocrine organs and kidneys from an additional 33 addicts were studied together with endocrine organs and kidneys from 20 'normal' persons. All 83 persons were submitted for medico-legal autopsy at the Institute of Forensic Medicine in Copenhagen. In fresh injection marks haemorrhage in dermis and subcutis was present histologically in all cases. Acute inflammation was present in 38% and acute inflammation together with chronic changes in 41%. Fibrotic thickening of vein wall was seen in 14% and thrombosis in 10%. Birefringent foreign material occurred in 35%. In old injection marks and scars chronic inflammatory changes were observed in 93%, fibrotic thickening of vein wall in 20% and thrombosis in 10% of the cases. Birefringent material occurred in 17%. By comparison of changes in injection marks with the size and histological changes in the corresponding axillary lymph nodes, there was a tendency to a relation between chronic inflammatory changes in old injection marks/scars and enlargement of the lymph nodes in question, but no correlation to the histological degree of immunoactivity. Regarding alterations in the endocrine organs and the kidneys no important differences were demonstrated between drug addicts and 'normal' persons.

Topics: Adrenal Glands; Adult; Cicatrix; Endocrine Glands; Female; Heroin; Heroin Dependence; Humans; Injections, Intravenous; Kidney; Male; Morphine; Morphine Dependence; Ovary; Pituitary Gland; Skin; Testis; Thyroid Gland; Veins

Topics: Cicatrix; Heroin; Humans; Injections, Intravenous; Morphine Dependence; Substance-Related Disorders