Behandlungsstrategien und Ergebnisse bei injektionsassoziierten inguinalen perivaskulären Abszessen bei intravenös Drogenabhängigen

BACKGROUND: Long-term drug users regularly present with deep inguinal vascular-associated abscesses due to continued drug injections utilizing superficial veins. The treatment of these complications continues to be a major medical challenge. So far no uniform treatment regimens have been described in the literature. OBJECTIVE: What are the treatment strategies and outcomes of injection-associated inguinal perivascular abscesses in drug addicts? MATERIAL AND METHODS: All drug users treated at the Augsburg University Hospital in the period between 1 January 2004 and 31 May 2019 were retrospectively reviewed and compared with the currently available literature. RESULTS: In this study 37 cases (male = 25, female = 12) could be included in the data collection after implementation of the inclusion criteria. The median age in the investigated patient population was 34.3 years. The 30-day mortality was 2.7% (1/37). The amputation rate was 2.8%. In the investigated collective 13 patients had arterial involvement, in 5 cases a ligature of arteries was primarily used and in another 5 cases a reconstruction using an autologous conduit graft was primarily performed. In another 3 cases an obturator bypass (1/3) was placed and a patch plasty (2/3). The patency rate after arterial reconstruction was 87.5% with a mean follow-up of 421 days. The overall complication rate was 51.4%. CONCLUSION: For vascular involvement an approach appropriate for the situation is meaningful. In addition to the elimination of complicated septic venous thromboses, the correction of arterial hemorrhages using autologous reconstruction measures seems promising.