1887
Volume 2017, Issue 1
  • ISSN: 1999-7086
  • E-ISSN: 1999-7094

Abstract

Emergency department physicians can easily underestimate the severity of damage underlying the innocuous looking high-pressure injection injuries. These work-related injuries lead to significant lifelong morbidity as functionality is compromised in most cases, even after recovery due to high rates of amputation. Hence it is important to consider all high-pressure injection injuries as surgical emergencies. A detailed case history including pressure of the instrument, nature of the material, volume injected, angle of injection and time since injury should guide the treatment. Immediate debridement, antibiotic therapy and postoperative care are essential in all cases. Success of the treatment largely depends on early initiation of the therapy. Relying exclusively on non-surgical interventions may not be favorable in most cases as the injected material will continue damaging the internal tissues. Patients have to undergo a long recovery period with physiotherapy to regain the functionality of the affected region. However, the sensory and motor functions will never be returned to normal levels in these injuries.

Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2017.1
2017-05-10
2019-11-14
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2017/1/jemtac.2017.1.html?itemId=/content/journals/10.5339/jemtac.2017.1&mimeType=html&fmt=ahah

References

  1. Neal N, Burke F. High-pressure injection injuries. Injury. 1991; 22:6:467470.
    [Google Scholar]
  2. Rees C. Penetration of tissue by fuel oil under high pressure from diesel engine. JAMA. 1937; 109:11:866867.
    [Google Scholar]
  3. Gelberman RH, Posch JL, Jurist J. High-pressure injection injuries of the hand. J Bone Joint Surg Am. 1975; 57:7:935937.
    [Google Scholar]
  4. Blue A, Dirstine M. Grease gun damage: subcutaneous injection of paint, grease, and other materials by pressure guns. Northwest Med. 1965; 64::342.
    [Google Scholar]
  5. Verhoeven N, Hierner R. High-pressure injection injury of the hand: an often underestimated trauma: case report with study of the literature. Strategies Trauma Limb Reconstr. 2008; 3:1:2733.
    [Google Scholar]
  6. Schoo MJ, Scott FA, Boswick JR JA. High-pressure injection injuries of the hand. J Trauma Acute Care Surg. 1980; 20:3:229238.
    [Google Scholar]
  7. Sirio C, Smith Jr J, Graham 3rd W. High-pressure injection injuries of the hand. A review. Am Surg. 1989; 55:12:714718.
    [Google Scholar]
  8. Pinto MR, Turkula-Pinto LD, Cooney WP, Wood MB, Dobyns JH. High-pressure injection injuries of the hand: review of 25 patients managed by open wound technique. J Hand Surg. 1993; 18:1:125130.
    [Google Scholar]
  9. Wieder A, Lapid O, Plakht Y, Sagi A. Long-term follow-up of high-pressure injection injuries to the hand. Plast Reconstr Surg. 2006; 117:1:186189.
    [Google Scholar]
  10. Weltmer J, Pack L. High-pressure water-gun injection injuries to the extremities. A report of six cases. J Bone Joint Surg Am. 1988; 70:8:12211223.
    [Google Scholar]
  11. Behar TA, Anderson EE, Barwick WJ, Mohler JL. Sclerosing lipogranulomatosis: a case report of scrotal injection of automobile transmission fluid and literature review of subcutaneous injection of oils. Plast Reconstr Surg. 1993; 91:2:352361.
    [Google Scholar]
  12. Kaufman H. The clinicopathological correlation of high-pressure injection injuries. Br J Surg. 1968; 55:3:214218.
    [Google Scholar]
  13. Couzens G, Burke F. Veterinary high pressure injection injuries with inoculations for larger animals. J Hand Surg [Br]. 1995; 20:4:497499.
    [Google Scholar]
  14. Barr ST, Wittenborn W, Nguyen D, Beatty E. High-pressure cement injection injury of the hand: a case report. J Hand Surg. 2002; 27:2:347349.
    [Google Scholar]
  15. Smith G. High pressure injection injuries. Trauma. 2005; 7:2:95103.
    [Google Scholar]
  16. Wei DH, Strauch RJ. High-pressure injection injuries. Fingertip Injuries: Springer; 2015. p. 73–81.
  17. McClinton MA, Wright S. High-pressure tool injection injuries. Md Med J. 1985; 34:3:289291.
    [Google Scholar]
  18. Waters WR, Penn I, Ross HM. Airless paint gun injuries of the hand: a clinical and experimental study. Plast Reconstr Surg. 1967; 39:6:613618.
    [Google Scholar]
  19. Kaufman H. The anatomy of experimentally produced high-pressure injection injuries of the hand. Br J Surg. 1968; 55:5:340344.
    [Google Scholar]
  20. Stark HH, Ashworth CR, Boyes JH. Paint-gun injuries of the hand. J Bone Joint Surg Am. 1967; 49:4:637647.
    [Google Scholar]
  21. Gillespie CA, Rodeheaver GT, Smith S, Edgerton MT, Edlich RF. Airless paint gun injuries: definition and management. Am J Surg. 1974; 128:3:383391.
    [Google Scholar]
  22. Rimmer M, King J, Franklin A. Accidental injection of white spirit into the hand in golfers. J Hand Surg [Br]. 1993; 18:5:654655.
    [Google Scholar]
  23. Christodoulou L, Melikyan EY, Woodbridge S, Burke FD. Functional outcome of high-pressure injection injuries of the hand. J Trauma Acute Care Surg. 2001; 50:4:717720.
    [Google Scholar]
  24. Green S. Injection injuries of the hand. Bull Hosp Jt Dis Orthop Inst. 1980; 41::4858.
    [Google Scholar]
  25. Dickson RA. High pressure injection injuries of the hand a clinical, chemical and histological study. Hand. 1976; 8:2:189193.
    [Google Scholar]
  26. Lewis H, Clarke P, Kneafsey B, Brennen M. A 10-year review of high-pressure injection injuries to the hand. J Hand Surg [Br]. 1998; 23:4:479481.
    [Google Scholar]
  27. Hogan CJ, Ruland RT. High-pressure injection injuries to the upper extremity: a review of the literature. J Orthop Trauma. 2006; 20:7:503511.
    [Google Scholar]
  28. Pai C-H, Wei D-C, Hou S-P. High-pressure injection injuries of the hand. J Trauma Acute Care Surg. 1991; 31:1:110112.
    [Google Scholar]
  29. Bottoms R. A case of high pressure hydraulic tool injury to the hand, its treatment aided by dexamethasone and a plea for further trial of this substance. Med J Aust. 1962; 49::591592.
    [Google Scholar]
  30. Mirzayan R, Schnall SB, Chon JH, Holtom PD, Patzakis MJ, Stevanovic MV. Culture results and amputation rates in high-pressure paint gun injuries of the hand. Orthopedics. 2001; 24:6:587589.
    [Google Scholar]
  31. Ramos H, Posch JL, Lie KK. High-pressure injection injuries of the hand. Plast Reconstr Surg. 1970; 45:3:221226.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.5339/jemtac.2017.1
Loading
/content/journals/10.5339/jemtac.2017.1
Loading

Data & Media loading...

  • Article Type: Review Article
Keyword(s): early diagnosis , early referral , Emergency department and Highpressure injection injury
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error