Case Series/Study
The rapid and near complete resolution of SE prevented urgent surgical exploration and development of possible compartment syndrome. When SE resolved, a complete physical exam was performed which revealed injury to the extensor digiti minimi, extensor pollicis longus and possible posterior interosseous nerve. Patient was taken to the OR electively for exploration and repair of his injuries. The high-pressure water gun had cut cleanly through skin, muscle, and tissue like a knife down to the bone with minimal collateral injury.
Although initially alarming, traumatic SE in an otherwise minor wound (as featured in this case) does not necessitate emergent surgery. Careful evaluation of the patient's history, clinical examination findings, laboratory studies and imaging can help guide physicians in the management of traumatic subcutaneous emphysema and potentially avoid unnecessary emergent surgical intervention. In this case NPWT temporized the traumatic SE clinically, which allowed for a thorough comprehensive physical examination.