High Pressure Injection Injury

This seemingly innocuous injury is often underestimated and underrecognized. The injury is characterized by a small puncture wound and injection of liquid (lubricants, oils, solvents etc) into the hand using high pressure guns (2000 to 12000 psi). The wounds are small, but the underlying damage is usually extensive. The injected substance leads to extensive tissue damage (local necrosis and oedema). As a result, this may lead to compartment syndrome of the affected limb. Due to their potential morbidity, injection injuries are characterized as “the most urgent of all emergencies of the hand”

These patients would require immediate referral to the Hand Surgeons for debridement. ED management includes intravenous antibiotics and tetanus prophylaxis.