Abstract
Objectives: Oil-based high-pressure injection injuries may cause serious hand injuries. Unless proper surgical interventions are performed, this situation contains a high possibility of serious sequels. It is aimed to present the management of high-pressure injection injuries with paint gun.
Methods: Between 2013 and 2019, five male patients with the mean age of 34,4, admitted to our clinic with hand injuries and subcutaneous oil-based materials injection caused by high-pressure paint guns. Broad debridement was performed by dissection and adventitiectomy of the vessel and nerve bundles under magnification. Postoperative clinical follow-ups, Quantitative Sensory Testing results, and chemical properties of the injected materials are obtained.
Results: Pain was the most common complaint in the early postoperative period. Injected materials were oil-based paints and mineral oils, both have a pH between eight and nine. We observed partial skin and subcutaneous tissue necrosis but none of the patients required amputation. Static two-point discrimination values were obtained post-op 12th month, varied between 7 and 11 mm (mean 8 mm) at the pulp of the affected finger innervated by the affected nerve endings. Cold intolerance was the most common complaint in the chronic phase. The worst clinical outcome among these patients, one had chronic infection and fistulas around the injected fingers due to late admission to our clinic by the 6th day of post-injury without any emergent treatment prior.
Conclusion: To reduce permanent impairments in high-pressure injection injuries of the hand, early decompression and debridement under microsurgical operation settings are important. Therefore, patients should be operated as soon as possible to improve outcomes.

Key words: Keywords: pressure; injection; hand; microsurgery; debridement