Non-infective subcutaneous emphysema of the hand—is fasciotomy required?

Abstract

Background Presence of gas in the subcutaneous tissue in a limb is always worrisome. Majority of the cases occur due to infection by gas-forming organism and less commonly due to non-infectious causes. Case report We report a case of 52-year-old male who presented with an acute onset rapidly spreading swelling of the hand and forearm following a minor splinter injury. There was no distal neurovascular compromise. He underwent an emergency fasciotomy. Discussion Here we discuss about non-infective subcutaneous emphysema of the limbs and the need to be aware of this potentially harmless condition. We believe that even in minor injuries resulting in extensive non-infective emphysema, a prophylactic decompression even in the absence of neurovascular compromise would be a prudent action, which does not necessarily lead to increased morbidity.