The acute pathologic changes of paint-injection injury and correlation to surgical treatment: a report of two cases.

The early histologic changes of digital tissues after paint-injection injury support the urgent need to remove all contaminated tissue. Paint causes immediate tissue necrosis on contact and then incites an immediate necrotizing inflammatory reaction that persists if the tissues are not completely debrided. Early histopathologic changes include vessel thrombosis, tissue necrosis, and acute necrotizing inflammatory infiltrate, all occurring only hours after injection injury. In light of these histologic changes, if paint cannot be completely removed from digital arteries in an attempt to salvage the finger, then the wound should be left open and the finger monitored for further necrosis in response to the retained paint.