Review Question - QID 213980

Organic solvents, such as paint thinners carry the highest amputation risk, upwards of 50%.

High-pressure injection injuries are serious problems despite the often-benign appearance of the entry wound. Typically, treatment consists of broad-spectrum antibiotics and urgent irrigation and debridement. The composition of the injected material and timing to presentation are two of the most important factors leading to amputation risk. Grease, latex, chlorofluorocarbon and water-based paint products are less destructive to the soft tissue when compared to organic solvents such as paint thinners and engine fuel. Delay in treatment >10 hours has also been shown to increase the risk of amputation.

Hogan et al reviewed high-pressure injection injuries to the upper extremity. They report an amputation rate of 30%, with the injected material and location contributing most to the need for amputation. They conclude that urgent surgical debridement, especially within 6 hours decreases the risk of amputation.

Rosenwasser et al reviewed high-pressure injection injuries to the hand. They report that urgent and thorough debridement are crucial factors in the treatment of these injuries. They conclude that functional outcomes are dependent upon the initial wounding force, chemical properties and timing of debridement.

Incorrect Answers:
Answer 1-3, 5: Grease, latex, chlorofluorocarbon, and water-based paints are less destructive materials. Industrial solvents (paint thinner) and oil-based paints cause the most soft tissue destruction.