Table 2 Summary of qualitative findings

SSTI description

Progression of SSTI from cellulitis to abscess

An abscess is an infection that is under your skin, that is full of pus, and need to be cut open and drained.

Progression to “point of no return”

I wait until they get really big and the surface skin is bulging out and its all red, except for the tip is white where it’s the thinnest.

SSTI causes

Missed injections

I missed a portion of the shot into my arm. I missed the vein, so that was the reason for the infection.

Hygiene and sanitation

Not using clean supplies. I think my problem maybe if I have not just showered, if I’ve been working all day.

I’ve seen people not use alcohol wipes. You cannot do that. You cannot, you know, get ready to shoot yourself in the arm and not use an alcohol wipe.

Signs of a SSTI

Presentation of early SSTI symptoms

It gets red and it gets hot and it hurts. It gets to a point when you just cannot bear it any more.

Because I’ve seen it when it’s blown up or whatever and they cannot even more their hand and stuff like that anymore. That’s when it’s become so infected.

Early SSTI treatment

General health and well-being practices

Little things like drink a lot of liquids, make sure you sleep every night. Make sure you get enough sleep, drink liquids, eat regularly. These are key points.

Application of hot compress and salve

It all depends. If you catch it right off the bat, you can get some type of a hot pad or something, and put it on there. You continue to do that procedure.

My thing, I swear by it, draw-out salve.

Late SSTI treatment

Antibiotics from nontraditional sources

You can go into the aquarium, the fish store. They have antibiotics there that are for the fish. And they will go and they will get them and they will take them.

I sold antibiotics.

Wound care

I use wet-to-dry bandages with another bandage on the top of it. It’ll help it drain it and it will debride the dead tissue when you pull it out three times a day.

Needle aspiration

A lot of people will take needles and put them in there and try to drain the fluid out like that.

Incision and drainage procedure

I would lance it and squeeze it. I pull the skin apart as I’m pushing down on it.

I think it’s called expression? To open it up, to try and get all the material out. I cannot remember the term … Irrigate. People use a large syringe, preferably with the cleanest water they can get.

Traumatic past experiences within the formal health care system

Psychological trauma

He was mean and cold and short with me. I felt like he did not want to touch me.

I did not get treated very well at all. It was almost like that attitude that ‘You put yourself here. What are you going to expect us to do? I hope you do suffer’

Physical trauma

Incorrect treatment, when they cut a larger part than they needed to, mainly to increase pain...

...and literally made it worse than it had to be. You know, inflicted as much pain as they could. By not administering anesthetic and not enough of what they did, and then just grinding away at you in a way that was very unprofessional. ‘Maybe this will teach you a lesson about using drugs’.