In the initial weeks since becoming Medical Director of Division of Substance Use Prevention and Harm Reduction (SUPHR), it quickly became apparent to Dr. Daniel Teixeira da Silva, MD, MSHP that wounds and Skin and Soft Tissue Infection (SSTI) among people who use drugs (PWUD) would become a priority. ED visits for SSTIs among PWUD have tripled since 2019 and over 1,800 PWUD are hospitalized with SSTIs every year. Street harm reduction outreach teams and mobile medical teams report the number and severity of wounds exceeds the resources they have to treat them. More troubling, many patients report declining or delaying care despite the risk that wounds from injection drug use pose to their safety and well-being. The need was identified to develop standards of care and increase local capacity for the care of wounds and SSTIs among PWUD.

SUPHR and the Health Federation of Philadelphia's SURGE Program established a Wound and Skin and Soft Tissue Morbidity and Mortality Review Workgroup. The group met every other month starting in January 2023 to review cases and information, and they are currently working towards releasing a document of wound care recommendations.

"It’s given me a better understanding of the landscape, and what others are doing, and also just how to understand patients struggling with opioid use disorder. I attended a case discussion on wound care [presented by Rachel McFadden, BSN, RN] for individuals that are struggling with opioid use disorder, and that was very helpful for me for multiple reasons. It was challenging…but I appreciated [Rachel’s] perspective, just how she looked at the whole person. I have a quote that she said that’s sitting on my desk. She was quoting someone else saying to...look at the W-H-O-L-E person instead of looking at the H-O-L-E in the person. When you’re looking at wounds, do you just focus on the wound and forget the person and everything that caused them to have this wound…how their life has been challenged emotionally and relationally and everything because of these wounds? I thought that was just such an important perspective on how we care for this struggling group of individuals."

--Dr. Maryann Salib, DO, MPH, Associate Medical Director of Community Health and Wellness at Esperanza Health Center