High-pressure injection injury: Difference between revisions
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==Background== | ==Background== | ||
*Surgical emergency | |||
**Amputation rates are as high as 30% | |||
*Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand | *Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand | ||
*Most important factor is type of injected material | *Most important factor is type of injected material | ||
**Paint produces large, early inflammatory response w/ high rate of amputation | **Paint produces large, early inflammatory response w/ high rate of amputation | ||
**Grease causes small inflammatory response w/ lower rate of amputation | **Grease causes small inflammatory response w/ lower rate of amputation | ||
==Diagnosis== | ==Diagnosis== | ||
*Benign appearance of small injection site in immediate | *Benign appearance of small injection site in immediate post-injection period is misleading | ||
**With time digit becomes edematous, pale, and severely tender to palpation | **With time digit becomes edematous, pale, and severely tender to palpation | ||
*X-ray | *X-ray | ||
Revision as of 19:02, 28 February 2012
Background
- Surgical emergency
- Amputation rates are as high as 30%
- Occurs with grease, paint, and fuel guns; usually injected into non-dominant hand
- Most important factor is type of injected material
- Paint produces large, early inflammatory response w/ high rate of amputation
- Grease causes small inflammatory response w/ lower rate of amputation
Diagnosis
- Benign appearance of small injection site in immediate post-injection period is misleading
- With time digit becomes edematous, pale, and severely tender to palpation
- X-ray
- May show extent of injection of radiopaque substances
Treatment
- Early surgical decompression and debridement
- Immobilize and elevate affected hand
- Tetanus
- Abx
- Analgesia
- Digital blocks are contraindicated
Source
Tintinalli's