Xylazine-Associated Necrotic Upper-Extremity Wounds DOI
S. Arango, JOSEPH C. FLYNN, Jacob Zeitlin

et al.

Journal of Bone and Joint Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 23, 2024

Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe complex xylazine-associated (XAN) wounds, the aim this consecutive series was characterize variability presentations (ranging from mild severe) at single institution epicenter xylazine epidemic. Methods: Patients presenting tertiary referral center for XAN wounds were retrospectively identified emergency department visits hospital admissions between January 2021 December 2023. Patient characteristics, clinical findings, treatment, hospitalization-related measures recorded. Wounds classified according depth, density, size, presence osteomyelitis. All variables quantified using descriptive statistics. Results: In total, 82 patients with 125 included study. mean age 40.3 ± 8.2 years, 57% men. Of 54% had associated osteomyelitis, 78% confluent, 47%involved more than two-thirds anatomic region. Surgery recommended performed 62%, 13% undergoing amputation. Complications rates high (77%) bacteremia (40%) death (5%). hospitalized 4.1 times discharged against medical advice 2.8 per year. Conclusions: This study presents broad perspective demographic, social, factors upper extremity. Given complexity burden public health crisis, early intervention is important prevent complications mitigate costs. Level Evidence: Therapeutic IV . See Instructions Authors complete description levels evidence.

Language: Английский

Xylazine-Associated Necrotic Upper-Extremity Wounds DOI
S. Arango, JOSEPH C. FLYNN, Jacob Zeitlin

et al.

Journal of Bone and Joint Surgery, Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 23, 2024

Background: The rise in xylazine-adulterated heroin and fentanyl poses novel challenges to hand surgeons a rising epidemic of necrotic upper-extremity wounds. While prior case studies have focused on particularly severe complex xylazine-associated (XAN) wounds, the aim this consecutive series was characterize variability presentations (ranging from mild severe) at single institution epicenter xylazine epidemic. Methods: Patients presenting tertiary referral center for XAN wounds were retrospectively identified emergency department visits hospital admissions between January 2021 December 2023. Patient characteristics, clinical findings, treatment, hospitalization-related measures recorded. Wounds classified according depth, density, size, presence osteomyelitis. All variables quantified using descriptive statistics. Results: In total, 82 patients with 125 included study. mean age 40.3 ± 8.2 years, 57% men. Of 54% had associated osteomyelitis, 78% confluent, 47%involved more than two-thirds anatomic region. Surgery recommended performed 62%, 13% undergoing amputation. Complications rates high (77%) bacteremia (40%) death (5%). hospitalized 4.1 times discharged against medical advice 2.8 per year. Conclusions: This study presents broad perspective demographic, social, factors upper extremity. Given complexity burden public health crisis, early intervention is important prevent complications mitigate costs. Level Evidence: Therapeutic IV . See Instructions Authors complete description levels evidence.

Language: Английский

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