Effectiveness of dorsal perforator flap of cross-finger proper digital artery in treatment of high-pressure injection injuries of the finger / 中国修复重建外科杂志

OBJECTIVE@#To investigate the effectiveness of dorsal perforator flap of cross-finger proper digital artery in the treatment of finger soft tissue defect caused by high-pressure injection injury.@*METHODS@#Between July 2011 and June 2020, 14 cases of finger soft tissue defect caused by high-pressure injection injury were repaired with dorsal perforator flap of cross-finger proper digital artery. All patients were male, with a mean age of 36 years (range, 22-56 years). The defects were located on the index finger in 8 cases, middle finger in 4 cases, and ring finger in 2 cases. The causes of injury include 8 cases of emulsion paint injection, 4 cases of oil paint injection, and 2 cases of cement injection. The time from injury to debridement was 2-8 hours, with a mean time of 4.5 hours. The soft tissue defects sized from 4.0 cm×1.2 cm to 6.0 cm×2.0 cm. The flaps sized from 4.5 cm×1.5 cm to 6.5 cm×2.5 cm. The donor site of the flap was repaired with skin graft. The pedicle was cut off at 3 weeks after operation, and followed by functional exercise.@*RESULTS@#All flaps and skin grafts at donor sites survived, and the wounds healed by first intention. Twelve patients were followed-up 16-38 months (mean, 22.6 months). The texture and appearance of all flaps were satisfactory. The color and texture of the flaps were similar to those of the surrounding tissues. The two-point discrimination of the flap was 10-12 mm, with a mean of 11.5 mm. There were different degrees of cold intolerance at the end of the affected fingers. At last follow-up, the finger function was evaluated according to the Upper Extremity Functional Evaluation Standard set up by Hand Surgery Branch of Chinese Medical Association, 3 cases were excellent, 8 cases were good, and 1 case was poor.@*CONCLUSION@#The dorsal perforator flap of cross-finger proper digital artery can effectively repair finger soft tissue defect caused by high-pressure injection injury. The operation was simple, and the appearance and function of the finger recover well.

A Case of Subconjunctival Oil Granuloma caused by a High Pressure Injection Injury by Bunker Fuel Oil C

PURPOSE: To report a rare case of subconjunctival oil granuloma caused by a high-pressure injection injury that showed excellent cosmetic result after tissue resection and conjunctival autograft. METHODS: A 49-year-old male was injured by the high-pressure sprouting of bunker fuel oil C in his right eye during ship work. Temporal bulbar conjunctival laceration and subconjunctival oil involving the nasal subconjunctival area were observed on the initial examination. Irrigation and aspiration of subconjunctival oil was performed, but the result was not satisfactory. After wound healing of the conjunctiva, radical resection and biopsy of the conjunctival and tenon tissue that formed the fibrotic adhesion around laceration wound was performed. Then, the superotemporal bulbar conjunctiva of contralateral eye was grafted to the lesion. RESULTS: Bunker fuel oil C in the subconjunctival space did not invade the intraocular area. However, excisional biopsy of the scarred lesion showed chronic granulomatous inflammation. Satisfactory cosmetic outcome was achieved after conjunctival autograft without any complications.