High-pressure hand injection injuries caused by dry cleaning solvents: case reports, review of the literature, and treatment guidelines.

A previously unreported subset of high-pressure injection injuries, namely those involving solvents used in the garment dry cleaning industry, is presented. Dry cleaning solutions contain isoparaffinic hydrocarbons, methoxypropanol, and dichlorofluoroethane. Although these solvents have limited potential for systemic toxicity, severe local toxicity causing tissue necrosis often results in loss of the injured digit. Proper treatment includes prompt surgical exploration, careful débridement and irrigation, intravenous antibiotics, and in selected cases, high-dose systemic corticosteroids.