Xylazine, a veterinary sedative, has increasingly been found as an adulterant in illicit fentanyl supplies across the USA. This combination has led to severe necrotic skin wounds among users, particularly in the Philadelphia region, posing significant challenges for patients and healthcare providers. As these frequently exhibit as extremity wounds, orthopaedic surgeons are amongst those involved in their care. We discuss the recent findings from the first regional symposium on this crisis with meeting co-chairs Drs. Asif Ilyas and Katharine Woozley. Dr. Ilyas is President of the Rothman Opioid Foundation, Partner and Fellowship Director at the Rothman Institute, and Professor, Vice Chair, and Associate Dean at the Drexel School of Medicine in Philadelphia, Pennsylvania. Dr. Woozley is an Associate Professor of Orthopaedic Surgery and Division Head of Hand and Nerve Surgery at Cooper Medical School in Camden, New Jersey.
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