Airless paint gun injuries: an update.

The airless paint gun delivers paint at pressures approximating 3,000 psi. Paint accidently injected into the skin under this pressure causes a devastating injury which is a result of the paint material, the level of bacterial contamination, and the pressure at which the paint is delivered. The time interval between injury and treatment seems a critical determinant of outcome. Decompression of the closed vascular compartments of the hand must be begun immediately to release the underlying tissue distended by the injected paint. Judicious wound debridement must be performed. Immediate antibiotic treatment is indicated in all patients. Studies seem to indicate that steroids limit the severity of inflammatory response. A regimen of hydrocortisone sodium succinate, 100 mg IV, administered immediately before surgery should be followed by a seven-day tapering course of oral prednisone starting with 40 mg on the first postoperative day. Recent safety measures and consumer warnings through the Consumer Product Safety Commission may reduce the number of airless paint gun injuries.