Dr Minhao Hu¹, Dr James Briffa¹, Dr Rory Middleton¹, Dr Robert Boyle¹

¹Launceston General Hospital, Launceston, Australia

Abstract:

Background: High-pressure industrial washers are commonplace implements used to clean machinery, yet pose significant occupational hazards. Utilizing heated water jets of 80-100°C and >2000PSi, a wide range of resultant injuries have been reported to result, including thermal burns, compartment syndrome, delayed osteomyelitis and digital amputation.

Methods: We report a case of a 0.25%TBSA dorsal foot/2nd toe full-thickness scald burn inflicted by momentary exposure to the high-pressure water stream in a 32yo mechanic while cleaning machinery with steel-toe boots on. Initially appearing as a superficial injury, continued progression prompted referral to the plastic surgery unit, where patient was subsequently managed successfully with burn excision down to paratenon and split thickness skin grafting, demonstrating 100% take on the 5th day.

Conclusions: High-pressure industrial washers are as ubiquitous as they are hazardous. Due to their mixed-mechanism, patterns of injury may vary significantly depending on the angle of impact, length of exposure, and temperature/pressure settings. Prompt recognition and a high index of suspicion is recommended in management of these injuries, which may initially present as seemingly-innocuous…

Biography:

Unaccredited Plastics Registrar at Launceston General Hospital