Research in Medicine

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Background: Hydrocarbon injection is a strange method of suicidal attempt however, it can be also seen in domestic and industrial accidents. Management of chemical cellulites and other complications are matters of controversy among surgeons. T present study aimed at determining the surgical approach in soft tissue injection of hydrocarbons. Materials and methods: For this descriptive study, 21 patients referred to Loghman hospital in Tehran with hydrocarbon injection in a 4-year period (2001—2005) were included. Results: Most of the patients were male, single and aged between 20-29 years. Approximately, half of the cases were opium addicted. Only 6 patients had a documented psychological problem and 5 patients had a previous suicidal attempt. Choline-estrase inhibitors with hydrocarbon carrier and base were the most common injected substances (in 10 patients). Anterior of forearm was the most frequent site of injection (in 15 patients). Pain and swelling in injection site (21 patients) were the most prevalent symptoms while localized tenderness (21 patients) and erythema (17 patients) were the most common signs. Most of patients had leukocytosis (18 patients) and normal chest x-ray. All of the patients have been operated during the first 24-hour following the admission. The most common early-operations were fasciotomy and debridement (13 patients) and the most common late-operation was skin graft (10 patients). The most frequent complication was skin irritation and then compartment syndrome. Conclusion: Close monitoring of injection site for local complications and monitoring for systemic complications seem to be necessary in these patients. The majority of patients will need at least one operation despite conservative management.

Keywords: Hydrocarbon toxicity, Chemical cellulites, Suicide attempt.

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