皮肤意外注射缓释丁丙诺啡后坏死组织的早期手术切除。

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE
Journal of Addiction Medicine Pub Date : 2024-09-01 Epub Date: 2024-06-11 DOI:10.1097/ADM.0000000000001327
Carly Taylor, Vanessa Loukas, Jasmine Muwonge, Jessica L Taylor, Joseph Boyle
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引用次数: 0

摘要

导言:皮下注射丁丙诺啡缓释剂是一种越来越常见的治疗阿片类药物使用障碍的方法。严重的不良事件非常罕见,而且可能很少为人所知。本报告介绍了一种早期外科干预方法,以解决因皮下注射丁丙诺啡位置错误而导致的组织坏死。我们回顾了将坏死反应与皮下注射丁丙诺啡的其他不良反应区分开来的识别特征,并为继续使用皮下注射丁丙诺啡治疗提供指导:一名 33 岁的患者在注射丁丙诺啡后一小时内返回诊所,报告说疼痛和皮肤变化与之前的注射不同。患者皮肤上出现了与早期坏死一致的不褪色红斑,医生建议其手术切除丁丙诺啡注射部位。患者手术部位的愈合并不复杂,在返回继续接受皮下注射丁丙诺啡治疗之前,患者接受了舌下注射丁丙诺啡治疗:讨论:虽然皮肤坏死是皮下注射丁丙诺啡的罕见并发症,但早期手术切除以限制损伤的情况尚未见报道。必须更好地了解皮肤坏死的体征和症状,以便及早干预和继续治疗:本病例证实了患者在皮肤坏死的情况下仍可继续使用皮下注射丁丙诺啡进行治疗,并证明了浅表注射缓释丁丙诺啡后早期手术干预的价值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Early Surgical Excision of Necrotic Tissue Following Unintentional Dermal Injection of Extended-Release Buprenorphine.

Introduction: Extended-release subcutaneous buprenorphine is an increasingly common treatment for opioid use disorder. Serious adverse events are rare and may be poorly understood. This report describes an early surgical intervention to address tissue necrosis resulting from misplaced subcutaneous buprenorphine injection. We review identifying characteristics that distinguish the necrotic reaction from other adverse effects of subcutaneous buprenorphine and offer guidance to continue treatment with subcutaneous buprenorphine.

Case report: A 33-year-old patient returned to clinic within an hour of his buprenorphine injection, reporting pain and skin changes unlike his previous injections. Non blanching erythema consistent with early necrosis was evident, and the patient was referred for surgical removal of his buprenorphine depot. The patient had uncomplicated healing of the surgical site and was provided sublingual buprenorphine before returning to continue treatment with subcutaneous buprenorphine.

Discussion: Although skin necrosis is known to be a rare complication of subcutaneous buprenorphine injection, early surgical excision to limit injury has not been described. Signs and symptoms of skin necrosis must be better understood to facilitate early intervention and continued treatment.

Conclusions: This case affirms that a patient may continue treatment with subcutaneous buprenorphine despite suffering skin necrosis and demonstrates the value of early surgical intervention after superficial placement of extended-release buprenorphine.

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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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