High-pressure penetration of chemically active substances under the skin is one of the rare mostly industrial injuries. This issue is important due to few reports on the treatment of such pathology in the world literature, high risk of severe early and late complications, possible unsatisfactory functional results and even amputation. The authors report reconstructive surgical treatment of high-pressure injection injury of the hand. Timely surgical procedures and different methods of soft tissue defect closure made it possible to avoid severe infectious complications and achieve almost complete functional recovery. The demonstrated scheme of staged reconstructive surgery could be recommended for patients with severe high-pressure injection injury of the hand.