@article{ref1,
title="Optimal irrigant in high pressure paint injection injuries of the hand",
journal="Plastic and reconstructive surgery. Global open",
year="2022",
author="Bascone, Corey M. and Sheber, Benjamin and Dave, Dattesh and Firriolo, Joseph M. and Pereira, Clifford",
volume="10",
number="1",
pages="e4064-e4064",
abstract="High pressure injection injury to the hand with paint leads to amputation rates near 48%. Historically, authors utilized saline irrigation alone, but have high reoperation rates. We conducted a cadaveric study to determine the ideal detergent for effective paint removal from the soft tissue. <br><br>METHODS: Two cadaveric hands were amputated from the same cadaver. The left and right hand digits were injected with flat white latex-based paint and flat white oil-based paint, respectively. Each digit received a longitudinal incision and was scrubbed for 120 seconds with 50 mL of a randomly assigned detergent and no detergent (saline) as the control. After achieving a lather, each finger was cleansed with 50 mL saline before being evaluated by two blinded hand surgery faculty. Reviewers assessed the washouts as adequate or inadequate, in order to generate a Kappa statistic and measure inter-rater reliability prior to ranking each digit (1 through 5) (ie, 1 = most paint-free soft tissue). <br><br>RESULTS: The two hand faculty had an inter-rater reliability of 0.70. Both reviewers ranked povidone-iodine 10% or Johnson & Johnson shampoo as the best irrigant for latex-based paint. In oil-based paint, povidone-iodine 10%, Johnson & Johnson, & Techni-care were ranked as top three. All reviewers reported detergents were better than saline alone. <br><br>CONCLUSIONS: The addition of detergent created an irrigant that removed both latex- and oil-based paint better than normal saline alone. Based on these results, surgeons treating high-pressure injection injury should consider using Povidone-Iodine 10% or Johnson & Johnson baby shampoo for latex- or oil-based paint.<p /> <p>Language: en</p>",
language="en",
issn="2169-7574",
doi="10.1097/GOX.0000000000004064",
url="http://dx.doi.org/10.1097/GOX.0000000000004064"
}