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Arch Hand Microsurg > Volume 24(3); 2019 > Article
Archives of Hand and Microsurgery 2019;24(3):225-233.
Published online September 1, 2019.
DOI: https://doi.org/10.12790/ahm.2019.24.3.225   
Outcomes of Neglected Paint Gun Hand Injuries: Neglected Patients
Han Sol Shin1, Soo Min Cha2, Hyun Dae Shin2
1Department of Orthopedic Surgery, Hallym University Sacred Heart Hospital, Anyang, Korea.
2Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea. hyunsd@cnu.ac.kr
Received: 10 March 2019   • Revised: 9 May 2019   • Accepted: 29 May 2019
Abstract
Purpose
We report a retrospective case series of patients who received delayed treatment for a paint gun hand injury.

Methods
From January 2001 to December 2016, 13 patients injured from the fingertip to the wrist and treated surgically after a 48-hour delay was evaluated. Basic demographic characteristics, injury mechanism, lesion, time-to-surgery, and degree of injury were investigated. The visual analogue scale (VAS) scores; Disabilities of the Arm, Shoulder, and Hand (DASH) scores; and Strickland evaluations were analyzed at least 2 years after injury.

Results
The surgery was performed at a mean 59.7 hours after injury. Soft tissue coverage was performed at a mean 8.2 days after the initial incision and debridement, and simple skin closure and full-thickness skin grafting were performed in 1 and 7 patients, respectively. Moreover, cross-finger flap, neurovascular island flap, retrograde island flap, and groin flap were used in one, one, one, and two patients, respectively. The mean follow-up period was 28.2 months, and the mean VAS and DASH scores were 0.92 and 36.3, respectively, whereas the outcomes of the Strickland evaluations were ‘good’ in two patients, ‘fair’ in seven patients, and ‘poor’ in four patients.

Conclusion
The recent mechanical development of paint guns has led to an increase in high-pressure injection injuries and resulted in greater accidental toxic paint injection into the fingers and hand. Thus, the toxic and inflammatory response progresses rapidly to acute compartment syndrome and necrosis, and delayed treatment is therefore associated with poor clinical outcomes.
Key Words: Paint, Gangrene, Flap
 
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