ArticleMicrosurgery2026
Free Flap Reconstruction of Xylazine-Associated Wounds: A Retrospective Review.
Article in Microsurgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundXylazine is a veterinary sedative that is added to illicit fentanyl to enhance its effects. Xylazine-associated wounds differ from those found in patients who inject other drugs. They are larger and frequently involve deeper structures, such as bone. The outcomes of reconstruction using free tissue transfer are not well understood.
methodsAll consecutive free flap reconstructions of xylazine-associated wounds at a tertiary care center in the northeast US between January 2021 and December 2024 were retrospectively reviewed. Data were stored in a HIPAA-compliant REDCap database.
resultsEleven free flap reconstructions were performed among 10 patients. Median age was 34 years (IQR: 31-38), all were White, 20% were Hispanic, and 90% were female. Median BMI was 20.9 (IQR: 19.9-39.3). Comorbidities included HCV (70%) and active tobacco smoking (60%). Wounds were located on the neck (9.1%), chest (18.2%), upper extremity (45.5%), and hand (27.3%). 81.8% presented with exposed bone. Median debridements were two (IQR 1-3). Free flaps included: four anterolateral thigh (36.4%), three gracilis (27.3%), one rectus abdominis (9.1%), one scapular (9.1%), one latissimus dorsi (9.1%), and one lateral arm (9.1%) flap. Two patients were discharged against medical advice (18.2%). Median follow-up was 364 days (IQR: 287-710). All flaps were viable at 3 weeks. Roughly half of patients (45.5%) continued to use injection drugs after reconstruction. Early complications included: one venous congestion requiring exploration and one partial flap dehiscence. Late complications included two surgical site infections and two wound recurrences due to continued xylazine use resulting in trans-humeral amputation (40% of those who continued to inject drugs).
conclusionFree tissue transfer can effectively reconstruct xylazine-associated wounds and is necessary for limb salvage in patients with exposed bone. All flaps were viable at 3 weeks. Late wound recurrence due to continued xylazine use is associated with poor outcomes, including amputation. Abstinence from injection drug use is critical to optimizing the chances of recovery, and a multidisciplinary approach is essential.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.