A well vascularised muscle flap--drug user's dream

It is estimated that worldwide, 16 million people, aged 15-64 years inject illicit drugs regularly. When peripheral venous access becomes obliterated, drug users start injecting into the subdermal area of the skin - "skin popping". When this area ulcerates, the well vascularised granulation tissue called a "shooter's patch" is maintained as a portal for continuing injection. These "shooter's patches" are usually on the limbs, but have been reported on the breast and the penis. We present a case of a reconstructive muscle flap being used in an unforeseen manner as a shooters patch. Surgeons rely on muscle flaps to provide a robust reconstructive option, but we have learnt that drug users value them for their rich vascularity and high absorption.