Surgical approach to hydrocarbon injection in upper extremities: Case series

Abstract

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.

Parenteral Hydrocarbon Injection and Associated Toxicities: Two Case Reports

“…Local injection site reactions occur and can result in cellulitis, fat necrosis, and abscess formation, which tend to be sterile 4,13,14. Subcutaneous injection has resulted in compartment syndrome and the need for fasciotomy 10,13. In particular, WD-40 ™ subcutaneous exposure is a rare occurrence, yet small volume injection (0.5 mL) has been associated with significant local skin reaction with cellulitis and profound leukocytosis as observed in our cases 15…”

“…7 Central nervous system effects vary greatly and range from mild euphoria to lethargy and seizures 4,8. Hematologic effects may include intravascular hemolysis and significant leukocytosis 5,9,10,11. Intravenous hydrocarbon exposure has caused respiratory failure with chemical pneumonitis and interstitial pulmonary edema with hypoxia 15.…”

Chemical Necrotising Fasciitis Secondary to Self-Injection of Permethrin Insecticide

“…7 Radiological examination may be helpful if the insecticide contains solvents like halogenated hydrocarbons which are radio-opaque, giving a better delineation of surgical margins. 13 However, the radiographic assessment of the right forearm of our patient was negative. Due to the lipid solubility of hydrocarbons which enables it to disperse along tissue planes and the lack of detoxification mechanisms of the body, the extensive tissue damages often result in multiple debridements.…”

Deliberate self-harm with parenteral chlorpyrifos: a case report

“…Finally, hydrocarbons solvents in OP formulations can be highly irritating to local tissues and may lead to soft tissue damage. Local injection site reactions like cellulitis, fat necrosis, compartment syndrome, and abscess formation, which tends to be sterile, can occur [13][14][15][16]. They may require treatment with anti-inflammatory agents and antimicrobials if contamination is suspected.…”