Harm Reduction Team, NHS Lothian, Edinburgh, UK.
Research & Evaluation Division, Knowledge Directorate, Public Health Wales, Cardiff, UK.
J Clin Nurs. 2021 Jun;30(11-12):1623-1632. doi: 10.1111/jocn.15716. Epub 2021 Feb 26.
The aim of this study was to assess, for the first time in a hard-to-reach population, the risk factors for leg ulceration among PWID, with the objective of making improvements to prevention and care.
An estimated 4.8 million people globally inject drugs with potential for injecting-related harm. Skin and vein damage associated with drug injecting is increasing. Leg ulceration is a chronic condition which in the UK has a prevalence of 15% among people who have injected drugs (PWID) compared with 1% in the general population. Glasgow has the highest rate of problematic drug use in Scotland with approximately 13,900 individuals, about 50% of whom are thought to inject. However, the reasons for high prevalence of leg ulceration among PWID are unknown. To support improvements in prevention and care, the dearth of evidence around risk factors for leg ulceration in PWID needs to be addressed.
A cross-sectional survey of 200 current and former injectors recruited from drug services in Glasgow, Scotland, to measure skin problems, leg ulceration and injecting habits is reported following STROBE guidelines. Logistic regression modelling examined whether demographics and injecting habits predicted leg ulceration.
The likelihood of leg ulceration was increased for those who injected in the groin and the leg. Additionally, injecting in the groin and leg were associated with having a DVT.
The primary risk factors for leg ulceration in PWID are injecting in the groin and the legs and these are clinically linked to deep vein thrombosis. Injecting into the femoral vein is increasingly common practice for PWID and healthcare practitioners should advise injectors of the increased risk of leg ulceration and DVT and discourage injecting into these areas.
本研究的目的是首次在难以接触的人群中评估静脉药物滥用者（PWID）发生腿部溃疡的风险因素，以期改善预防和护理措施。
全球估计有 480 万人注射毒品，存在与注射相关的伤害风险。与吸毒相关的皮肤和静脉损伤正在增加。腿部溃疡是一种慢性疾病，在英国，注射毒品的人群（PWID）中腿部溃疡的患病率为 15%，而普通人群中的患病率为 1%。格拉斯哥是苏格兰吸毒问题最严重的地区，约有 13900 人，其中约 50%的人被认为有注射毒品的习惯。然而，PWID 中腿部溃疡高发的原因尚不清楚。为了支持预防和护理措施的改进，需要解决 PWID 中腿部溃疡风险因素方面证据不足的问题。
按照 STROBE 指南，对苏格兰格拉斯哥的毒品服务机构招募的 200 名现用和曾经的吸毒者进行横断面调查，以测量皮肤问题、腿部溃疡和注射习惯。逻辑回归模型检验了人口统计学特征和注射习惯是否预测腿部溃疡。
在腹股沟和腿部注射的人腿部溃疡的可能性增加。此外，在腹股沟和腿部注射与深静脉血栓形成（DVT）有关。
PWID 腿部溃疡的主要危险因素是在腹股沟和腿部注射，这与深静脉血栓形成（DVT）密切相关。PWID 越来越多地在股静脉内注射，医护人员应告知注射者腿部溃疡和深静脉血栓形成（DVT）的风险增加，并劝阻在这些部位注射。
