Subcutaneous tissue emphysema of the hand secondary to noninfectious etiology: a report of two cases. J Hand Surg Am 1999 May;24(3):638-41
Date
06/05/1999Pubmed ID
10357548DOI
10.1053/jhsu.1999.0638Scopus ID
2-s2.0-0344435248 (requires institutional sign-in at Scopus site) 34 CitationsAbstract
Subcutaneous emphysema of the hand can be benign and noninfectious in origin. Emphysema from gas-forming organisms is associated with systemic symptoms, whereas benign subcutaneous emphysema is not. High-pressure pneumatic tool injuries are a well-known cause of subcutaneous emphysema. Minor wounds in the web space skin may result in a transport of air across the defect, acting like a ball valve mechanism to trap and then force the air into the subcutaneous tissue, as illustrated by 1 of our patients. In the second patient, use of a high-vibration tool without apparent breach of skin was associated with extensive subcutaneous emphysema. The benign nature of the emphysema was revealed by a lack of local pain and inflammation in the presence of extensive crepitus and a lack of systemic symptoms. A noninfectious cause should always be considered. This may prevent unnecessary surgical intervention, which occurred in 1 of the 2 cases presented here.
Author List
van der Molen AB, Birndorf M, Dzwierzynski WW, Sanger JRAuthors
William W. Dzwierzynski MD Professor in the Plastic Surgery department at Medical College of WisconsinJames R. Sanger MD Professor in the Plastic Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAnti-Bacterial Agents
Hand
Humans
Male
Middle Aged
Radiography
Subcutaneous Emphysema
