High pressure injection injuries: a serious occupational hazard.

Abstract

High pressure injection equipment such as airless paint sprayers, high pressure grease guns, and fuel injection apparatus constitute a serious safety hazard resulting in significant morbidity. These devices are capable of delivering contaminants such as paint, solvents, and grease at pressures ranging from 600-12,000 psi. This allows the substance to penetrate through a minute skin wound and to spread widely through fascial planes and tendon sheaths and to produce significant vascular compression and systemic toxicity. High pressure injection injuries frequently result in amputation. Fifty-five suspected high pressure injection injury cases were evaluated. Twenty were determined to be actual injection injuries from equipment producing pressures in the range of 1,500-12,000 psi. The injected contaminants included latex paint, mineral spirits, and concrete sealer. Fourteen injuries involved digits. Digital amputation was necessary in three patients. Hospital admissions averaged 6.5 days. Successful management of these cases involves awareness of the impending problem and rapid referral of the patient to an emergency department and to a competent orthopedic or plastic surgeon.