ABSCESS ANONG INJECTING DRUG USERS.

Abscess is a localized collection of pus and infected material in a body part. Whenever any germs or other materials enter the body, the body recognizes them as ‘foreign bodies’. As a reaction,the body deploys the white blood cells and other cells in its attempt to get the foreign body out. This results in collection of pus (which is generally made up of dead tissues, germs and white cells) in and around the foreign body, leading to formation of abscesses. Abscesses often take between two and five days to develop but sometimes can develop instantaneously. 

The affected part may be hot, red, swollen, tender and fluctuant (indicating pus formation).

Abscesses can occur in any part of the body. However, a majority of the IDUs have abscesses on the skin due to unsafe injecting practices. These are called cutaneous abscesses. This SOP addresses issues and management of cutaneous abscesses. Cutaneous abscesses are usually caused by common skin bacterium (Staphylococcus Aureus).

Abscesses can be of two types:

1. Exploding: where infection breaks out onto the outer skin surface.

2. Impounding: where the pus formation takes place under the skin and infection      keeps spreading under the skin, without breaking out onto the skin surface.

Why Abscesses Occur in IDUs? ( IDU- Injecting Drug User )

Abscesses are caused by germs, such as bacteria and foreign substances entering the body through needles piercing the skin and contaminating the injection site. An area of tissue becomes infected and initially looks like a hard boil. If ignored, white blood cells move into the infected area and collect within the damaged tissue and pus forms. If further ignored, the infected area could increase and break/ breach the skin leading to formation of an ulcer. If overlooked, the site could become infested with maggots after which gangrene could set in. This could result in amputation of the limb or infected part. In IDUs, abscesses occur because of a number of factors – from the drugs being injected to the unsafe injecting practices followed by the IDU. Finally, the physical status of the IDU may play a role in the formation of abscesses.