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Pentazocine ulceration
G B Irons1, D J Hodgkinson, G C Chong
1Department of Surgery, Mayo Clinic and Mayo Foundation, Rochester, MN 55901, USA.
Annals of Plastic Surgery
|April 4, 2009
Summary
Pentazocine, a potent pain reliever, can cause severe skin damage from misuse. Aggressive surgical removal and skin grafting are effective treatments for these pentazocine-induced tissue injuries.
Area of Science:
- Dermatology
- Pain Management
- Pharmacology
Background:
- A need exists for effective, non-addicting analgesics for intractable pain.
- Pentazocine was introduced as a potent analgesic with lower addiction potential than morphine or meperidine.
- Long-term use and self-administration of pentazocine have led to misuse and overuse.
Purpose of the Study:
- To describe the characteristic tissue changes resulting from pentazocine abuse.
- To evaluate treatment outcomes for patients with pentazocine-induced cutaneous complications.
Main Methods:
- Case series of 14 patients presenting with complications from parenteral pentazocine abuse.
- Clinical observation of characteristic cutaneous ulcerations, subcutaneous fibrosis, and fistulous tracts.
- Assessment of treatment responses, comparing conservative management with surgical intervention.
Main Results:
- Patients exhibited extensive cutaneous ulcerations, subcutaneous fibrosis, and multiple fistulous tracts.
- Conservative treatment approaches yielded poor responses.
- Aggressive surgical excision and split-thickness skin grafting resulted in the best outcomes.
Conclusions:
- Parenteral pentazocine abuse can lead to severe, characteristic tissue damage.
- Conservative management is often ineffective for these lesions.
- Aggressive surgical debridement and reconstruction offer the most effective treatment for pentazocine-induced tissue injury.
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