INJURIES OF the upper extremity caused by the wringer washing machine continue to occur commonly in children. Initially, the tissue damage may appear insignificant, which often leads to inadequate treatment. Prompt and aggressive therapy is necessary in all such injuries to prevent tissue loss and impairment of normal function. The experience gained in the management of 115 children with wringer injuries during the past two years forms the basis for this report.
The turning rollers of a wringer washing machine create two destructive forces—friction and compression. Friction injuries range in severity from mild abrasive burns to partial- and full-thickness skin losses. This avulsion occurs if the child forcibly resists the pull of the rollers or cannot release the wringer. Areas of subcutaneous hematoma and fat necrosis occur, and, if extensive, the overlying skin may be separated from its nutrient blood supply with resultant necrosis.
Compression forces produce edema in