The prevalence of skin scars on patients previously given intramuscular diclofenac injections, attending Universitas Academic Hospital Pain Clinic: a descriptive study
INTRODUCTION: An incidental finding of scarring after intramuscular Diclofenac was made at the Pain Clinic, Universitas Academic Hospital, Bloemfontein. The primary objective of our study was to document the prevalence of scars caused by these injections and to determine how patients obtained intramuscular diclofenac and who administered it to them. METHODS: A descriptive study was performed at the Pain Clinic. Informed consent was obtained and all patients attending (1st December 2013 – 31st August 2014) were included. Patients completed a questionnaire and the attending doctor examined the injection site. Data captured at examination included: site of injection(s) and skin changes. RESULTS: 131 patients were enrolled and data analysis was performed on 118 patients (these patients were completely sure injection they had received was diclofenac). Scarring was identified in 8.5% of the study population. The majority of patients received the IM diclofenac from general practitioners (41.5%), private pharmacists (30.6%) and hospital pharmacies (15%). Only 17.5% of the patients always had a prescription and 78.8% had not been warned against skin scars. Associated complications included pain, pruritus, erythema at the injection site, ulceration or skin damage, scarring and nausea. Four patients required medical treatment for a skin ulcer or abscess and 2 of these patients required surgical treatment. DISCUSSION: This study shows that the prevalence of scarring after intramuscular diclofenac injections in our study population is 8.5%. In the population studied, 28.2% of patients had the drug administered by an unqualified person, and only 17.5% always had a prescription. This study shows that 78.8% of the study population had never been warned about skin scars as a potential side effect.