Rush M D, Schoenfeld C N, Watson W A
Department of Emergency Medicine, Truman Medical Center, Kansas City, MO 64108, USA.
Am J Emerg Med. 1998 Sep;16(5):508-11. doi: 10.1016/s0735-6757(98)90004-3.
A 33-year-old white man injected approximately 4 cc of charcoal lighter fluid (99.4% naptha/0.6% inert ingredients) subcutaneously into his left antecubital fossa. The injection resulted in the toxic necrosis of his volar forearm skin extending proximally to mid-humerus and distally to the metacarpophalangeal joints of the left hand dorsally over a 6-day period. The patient ultimately required extensive surgical debridement, secondary operative closure, and approximately 150 cm2 of split-thickness skin grafting. This case demonstrates the potential for widespread, delayed toxic necrosis of the skin resulting from subcutaneous injection of naptha. This patient's case appears to represent the most severe and widespread case of toxic necrosis of the skin resulting from the subcutaneous injection of hydrocarbons reported in the literature. This case also demonstrates extensive toxic thrombophlebitis not reported in prior cases involving subcutaneous injection of hydrocarbons.
一名33岁的白人男性将约4毫升打火机油（99.4%石脑油/0.6%惰性成分）皮下注射到他的左肘前窝。此次注射导致其掌侧前臂皮肤发生中毒性坏死，在6天时间里，坏死范围近端延伸至肱骨中部，远端延伸至左手背的掌指关节。患者最终需要进行广泛的手术清创、二期手术缝合，以及约150平方厘米的中厚皮片移植。该病例表明，皮下注射石脑油可能导致皮肤广泛、延迟性中毒性坏死。该患者的病例似乎是文献报道的因皮下注射碳氢化合物导致皮肤中毒性坏死最严重、范围最广的病例。该病例还显示出先前皮下注射碳氢化合物的病例中未报道过的广泛中毒性血栓性静脉炎。
