Expanding WoundWell’s Initiative: Improving Outcomes for Patients With Xylazine-Related Wounds Through Enhanced Access to Daily Wound Dressings and Transportation Support

Grant Application

Raagini Jawa, MD, MPH, FASAM, Center for Research on Health Care, University of Pittsburgh, Margaret Shang MD, MS, University of Pittsburgh School of Medicine, and Cece Zamarripa PhD, MSN, RN, CWON, UPMC Presbyterian

Proposed Innovation

Xylazine is a veterinary sedative found in more than half of Allegheny County’s unregulated opioid drug supply. It causes severe necrotic wounds among people who use drugs (PWUD). Many of these individuals are homeless and lack insurance, transportation, and wound care supplies. With so many barriers to care, PWUD are at high risk for sepsis, amputations, and poor outcomes. A third of patients with xylazine wounds are hospitalized with preventable invasive infections and half are rehospitalized within 30 days.

UPMC currently operates 20 wound care clinics, but none provide low-barrier care integrated with addiction services for PWUD. This project seeks to expand UPMC’s new WoundWell program — western Pennsylvania’s first low-barrier wound care model for patients with xylazine-related wounds — to all UPMC wound clinics by 2027.

Improvements in Action

UPMC’s WoundWell program was launched in 2024 and initially served 46 patients with xylazine-related wounds. Offered through the Recovery Engagement Program, a primary care clinic at UPMC Mercy, the program provides wound and addiction care without requiring abstinence.

Through this project, WoundWell will provide hundreds of transportation vouchers and no-cost wound care supplies to uninsured patients.

Intended Outcomes

This project will create a sustainable, replicable care model that will ensure greater access to consistent, high-quality wound and addiction care for PWUD. This is expected to result in better wound healing, fewer emergency department visits and hospitalizations, and more patients in addiction recovery.