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.

METHOD: 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.