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- W2982208468 abstract "La toxicomanie est à l’origine de plaies chroniques (PC) responsables de complications sévères. Peu d’études sur ce sujet sont disponibles. Notre objectif était de déterminer les caractéristiques épidémiologiques, cliniques, étiologiques et évolutives de ces PC. Il s’agissait d’une étude rétrospective et prospective, multicentrique incluant tous les toxicomanes porteurs de PC. Nous avons inclus 58 patients (17 en prospectif) dont 84,5 % d’hommes, d’âge médian 43 ans, porteurs de PC multiples à la suite d’une toxicomanie intraveineuse (78,2 %), inhalée (41,1 %) ou nasale (20 %). La toxicomanie aux opiacés (68,4 %), à la cocaïne (47,4 %) ou au cannabis (40,4 %) était sevrée ou substituée dans 79,3 % des cas. Les PC étaient fibrineuses (53,6 %) et nécrotiques (42,9 %), récidivantes (54,2 %), évoluant depuis plus d’1 an (61,5 %). La toxicomanie intraveineuse était associée à des ulcères de grande taille, fibrineux, sur une insuffisance veino-lymphatique clinique dans 74 % des cas. Seules 23 % de ces plaies étaient localisées aux membres supérieurs. Les ulcères nécrotiques associés à une artériopathie clinique étaient associés à la voie inhalée. Les abcès (50 %) et érysipèles (29,3 %) étaient les complications cutanées les plus fréquentes. À 3 mois, 50 % des PC étaient améliorées et 29,2 % des patients étaient perdus de vue. Les PC chez les toxicomanes surviennent préférentiellement chez l’homme jeune avec antécédent de toxicomanie intraveineuse. Majoritairement aux jambes et associées à une insuffisance veino-lymphatique, elles engendrent un risque majeur d’infection cutanée augmentant la morbi-mortalité chez ces patients au suivi difficile. Drug addiction causes chronic wounds (CW) responsible for severe complications. Very few studies are available on this topic. The aim of our study was to describe the demographic, clinical and etiological characteristics as well as the course of CW in drug addicts. This was a retrospective and prospective multicenter study including all drug addicts with CW. We included 58 patients (17 prospectively), 84.5% of whom were male, of median age 43 years, presenting multiple CW as a result of intravenous (78.2%), inhaled (41.1%) and/or snorted (20%) drug abuse. Addiction to opioids (68.4%), cocaine (47.4%) and/or cannabis (40.4%) was ended and/or treated through substitution in 79.3% of patients. CW were fibrinous and necrotic (42.9 to 53.6%), recurrent (54.2%), and in some cases had been present for more than 1 year (61.5%). Intravenous drug addiction was associated with large, fibrinous, ulcers in a setting of venous and lymphatic insufficiency (74%). Only 23% of these wounds involved the upper limbs. Necrotic ulcers associated with clinical arteriopathy were described mainly with inhaled addiction. Abscesses (50%) and erysipelas (29.3%) were the most common cutaneous complications. After 3 months, 50% of CW were improved and 29.2% of patients were lost to follow-up. Drug abuse-related CW occurred preferentially in young men with history of intravenous abuse. For the most part, CW were seen on the legs and were associated with venous and lymphatic insufficiency, and the resulting major risk for cutaneous infection increased morbidity and mortality in this population in whom medical follow-up is inherently complicated." @default.
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- W2982208468 date "2019-12-01" @default.
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- W2982208468 title "Caractéristiques des plaies chroniques chez les toxicomanes : étude rétrospective de 58 patients" @default.
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- W2982208468 doi "https://doi.org/10.1016/j.annder.2019.09.004" @default.
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