High-Pressure Injection Injuries to the Face: An Unusual Case, Review of the Literature, and Proposed Management...

Area of Science:

• Trauma Surgery
• Plastic Surgery
• Ophthalmology

Background:

• High-pressure injection injuries are common in the hand but rarely reported in the face.
• Facial anatomy complexity and subtle initial symptoms can lead to underdiagnosis and delayed treatment.

Observation:

• A case of pressurized diesel fuel injection injury to the face is presented, entering at the base of the nare.
• The injury resulted in extensive liquefactive necrosis of facial, orbital, and neck subcutaneous fat.

Findings:

• The patient required serial operative debridements by plastic surgery, oculoplastic surgery, and otolaryngology over a 20-day hospital stay.
• Post-discharge, an infraorbital wound necessitated ectropion repair and full-thickness skin grafting.

Implications:

• Accurate assessment of the injury mechanism and underlying soft tissue damage is vital for facial injection injuries.
• Early surgical intervention and multidisciplinary care, including intensivists and ophthalmology, are essential for managing these severe injuries.