Surgical approach to hydrocarbon injection in upper extremities: case series.
BACKGROUND
Hydrocarbon injection, which mostly occurs in the upper extremity, is commonly seen in domestic and industrial accidents, or attempted suicide. Surgical approach to chemical cellulites and other complications in these patients is controversial.


METHODS
This survey has been carried out on 21 patients admitted to general surgery unit of Loqman Hakim hospital, Tehran, Iran with the complaint of hydrocarbon injection in 2001-2005.


RESULTS
The most common injected material was petroleum (in 8 patients). Anterior forearm was the most common injection site (in 16 patients). All of the patients had inflammation, swelling, and localized tenderness. Leukocytosis was present in 18 of 21 patients. Compartment syndrome happened in 13 patients; 5 with necrotizing fasciitis. All of the patients with compartment syndrome underwent fasciotomy and debridement. Split thickness skin graft was done for 10 patients after 2 weeks of admission. There was no mortality or limb loss during the study period.


CONCLUSIONS
Prevention of the systemic complications, hospitalization, close monitoring and treatment of chemical cellulites are the main parts of the management of patients with hydrocarbon injection. Surgical intervention is recommended when compartment syndrome or other local complications occur.
Farahvash
Mohammad Reza
MR
Department of Plastic Surgery, Imam Khomeini Hospital, Tehran Medical University, Iran.
Yegane
Rooh-Allah
RA
Bashashati
Mohammad
M
Ahmadi
Mina
M
Tabrizi
Nasim
N
D000062:Accidents, Occupational; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003161:Compartment Syndromes / Q000139:chemically induced / Q000601:surgery*; D003646:Debridement / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D019115:Fasciitis, Necrotizing / Q000139:chemically induced / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006838:Hydrocarbons / Q000506:poisoning*; D007273:Injections, Intramuscular; D007279:Injections, Subcutaneous; D007492:Iran; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D016038:Skin Transplantation; D013406:Suicide, Attempted; D013524:Surgical Flaps; D016896:Treatment Outcome; D034941:Upper Extremity; D014945:Wound Healing / Q000502:physiology; D055815:Young Adult
D006838:Hydrocarbons