High-pressure injection injury: Role of early detection and aggressive intervention

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.

Management of High-Pressure Injection Hand Injuries: A Multicentric, Retrospective, Observational Study

“…Bashir et al, (2017) [37] reported this correlation, showing an increase of the amputated subjects who had been treated after 10 h from injury. We found no strict correlation between the time (hours) of treatment after trauma and its outcome.…”

“…At the follow-up, a significantly better VAS was detected in the subjects treated ≤6 h from an accident. This could be put down to an early treatment of the phlogosis process caused by the material and the probable complications such as necrosis [37].…”