Xylazine-associated Wounds: Clinical Experience From a Low-barrier Wound Care Clinic in Philadelphia

Abstract

The veterinary sedative xylazine is spreading in unregulated opioid supplies across North America. Among people who use drugs with repeated exposure to xylazine, a distinct wound type has emerged. Here, we describe these wounds and share our experience treating them in a nurse-led, low-barrier wound care clinic in Philadelphia, PA. We propose a reimagining of wound treatment across settings to better serve people who use drugs, and we advocate for stronger protections against the harms of an increasingly adulterated drug supply. Our perspective from the epicenter of the xylazine crisis can inform the response of communities across the country who are starting to face harms associated with xylazine.

Figure 1

Progression and healing of a “tranq wound” in a WCC patient Panels 1–4 depict the progression of a xylazine-associated wound in a patient of the Prevention Point WCC. Some PWUDs and hospital-based wound specialists have noted similarities between these wounds and chemical burns. Panels 5–6 show healing in the same wound after surgical debridement during a hospitalization followed by ongoing community-based wound care.