Case report| Volume 65, ISSUE 3, P399-401, March 2012

A well vascularised muscle flap – Drug user’s dream

Published:August 29, 2011DOI:


      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.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Plastic, Reconstructive & Aesthetic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Mathers B.M.
        • Degenhardt L.
        • Phillips B.
        • et al.
        Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review.
        Lancet. 2008; 372: 1733-1745
        • Alvi A.
        • Ravichandran D.
        An unusual case of breast ulceration.
        Breast. 2006; 15: 115-116
        • White W.B.
        • Barrett S.
        Penile ulcer in heroin abuse: a case report.
        Cutis. 1982; 29 (69): 62-63
        • Tice A.D.
        An unusual, nonhealing ulcer on the forearm.
        N Engl J Med. 2002; 347: 1725-1726
        • Williams A.M.
        • Southern S.J.
        Conflicts in the treatment of chronic ulcers in drug addicts–case series and discussion.
        Br J Plast Surg. 2005; 58: 997-999