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ORIGINAL ARTICLE
Year : 2018  |  Volume : 8  |  Issue : 4  |  Page : 153-158

Limb ulcerations in patients who abuse pentazocine: A demographic and clinical study of an under-recognized etiology of hard-to-heal ulcers in Zaria, Northwest Nigeria


1 Division of Plastic Surgery, Ahmadu Bello University and Ahmadu Bello University, Teaching Hospital Zaria, Kaduna State, Nigeria
2 Department of Anesthesia, Ahmadu Bello University and Ahmadu Bello University, Teaching Hospital Zaria, Kaduna State, Nigeria
3 Department of Trauma and Orthopedic Surgery, Ahmadu Bello University and Ahmadu Bello University, Teaching Hospital Zaria, Kaduna State, Nigeria

Correspondence Address:
Dr. Abdulrasheed Ibrahim
Division of Plastic Surgery, Ahmadu Bello University and Ahmadu Bello University, Teaching Hospital Zaria, Kaduna State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ais.ais_33_19

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Background: Pentazocine-induced ulcerations are characterized by an indolent and intractable course. They constitute in their prolonged form a severely debilitating condition and require long-term multidisciplinary care. The purpose of this study was to analyze the sociodemographic and clinical profile of patients with pentazocine-induced ulcerations and highlight the unique set of challenges in their management. Patients and Method: This is a retrospective study of the clinical records for all patients with pentazocine-induced ulcerations from June 2002 to November 2013. The diagnosis was established by a past history of pentazocine abuse and the finding of chronic nonhealing ulcers on physical examination. Study variables included clinical presentation and outcome. The outcome was classified as healing following ulcer excision and skin grafts, healing following debridement and dressings, amputation, and loss to follow-up. Results: There were 8 males and 10 females with a mean age of 41 (range: 22–68 years). Employment in the health care profession was noted in eight patients: three were physicians and five were nurses. The time interval from the start of pentazocine injection to cutaneous changes ranged from 2 to 13 months. Ulcers were asymmetrical and deep with irregular shapes. The forearm and the thighs were the commonest locations of the ulcers. Split thickness skin graft after ulcer excision was done for two patients and skin grafts after repeated debridements in four patients. Two patients had above-elbow amputations and one patient had an above-the-knee amputation. Fifty percent (9 of 18 patients) refused surgical intervention and left the hospital against medical advice. Conclusion: In this study, there was a preponderance of pentazocine-induced ulcerations among middle-aged, college-educated medical or paramedical professionals. The majority of the ulcers were large, deforming, and indolent. Ulcer excision and split-thickness skin graft as well as treatment for drug dependence and social support are mandatory for an optimal outcome.


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