Puncture wounds caused by high-pressure injection of a substance

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Puncture wounds caused by high-pressure injection of a substance

Puncture wounds caused by the injection of a substance under high pressure into the skin are serious injuries. High-pressure equipment may be used for paint, paint thinner, grease, oil, fuel, or other liquid solvents. Most high-pressure injection injuries affect the hands and fingers. These injuries are at high risk for infection, swelling, underlying tissue injuries, and possibly amputation. The risk of amputation increases if medical treatment is delayed for 6 hours or more. Factors that determine the severity of an injection injury include:

• The type, toxicity, temperature, and thickness of the injected substance.
  • Paint, paint solvent, and paint thinner cause the highest risk of early tissue damage and serious complications. The risk for amputation because of complications from these injected substances is high.
  • Grease, oil, and hydraulic fluid may cause no visible reaction in the first few days after injection but serious complications can become apparent after the first 3 days. The risk of amputation because of complications from these injected substances is lower than from the paint substances themselves.
• The amount of substance injected. Larger amounts of fluid injected create more pressure on the blood vessels and other tissues.
• The speed and pressure settings of the equipment. Higher pressures cause more fluid to be injected.
• The site of injury. The left hand (or nondominant hand) is twice as likely to be involved than the right hand. The thumb and first two fingers are most likely to be injured.
• The interval between the time of the injury and the time of treatment.
• The spread of the injected substance into other tissues.
• Health risks that may increase the seriousness of your wound.

Credits

Last updated:	June 10, 2008
Author:	Jan Nissl, RN, BS
Reviewed By:	William M. Green, MD - Emergency Medicine, H. Michael O'Connor, MD - Emergency Medicine
Editors:	Susan Van Houten, RN, BSN, MBA, Tracy Landauer