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Chemical burns.

D W Mozingo1, A A Smith, W F McManus

  • 1U.S. Army Institute of Surgical Research, Fort Sam Houston, San Antonio, Texas 78234-6200.

The Journal of Trauma
|May 1, 1988
PubMed
Summary
This summary is machine-generated.

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Prompt removal of chemical agents and early recognition of systemic toxicity are crucial for chemical burn survival. This study analyzed 87 chemical burn cases, identifying white phosphorus as the most common cause and highlighting potential systemic complications.

Area of Science:

  • Toxicology
  • Dermatology
  • Emergency Medicine
  • Burn Surgery

Background:

  • Chemical skin injuries require immediate intervention to mitigate severity and improve outcomes.
  • Understanding causative agents and potential systemic effects is vital for effective management.
  • Previous data on chemical burn epidemiology and outcomes at a major military surgical center is limited.

Purpose of the Study:

  • To review the epidemiology and management of chemical burns over a 17-year period.
  • To identify common causative agents and associated systemic toxicities.
  • To evaluate treatment strategies and patient outcomes, including mortality and hospital stay.

Main Methods:

  • Retrospective analysis of 4,212 burn patients admitted between 1969 and 1985.

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  • Identification and categorization of 87 patients with chemical burns.
  • Review of causative agents, initial treatment (water lavage), wound management, systemic toxicity, and outcomes.

    • Main Results:

    • 87 chemical burns accounted for 2.1% of admissions, with a 13.8% mortality rate.
    • White phosphorus was the most frequent agent (49 cases), followed by acids, alkalies, and organic solvents.
    • Systemic toxicity (phenol, nitrate, formate) and acute tubular necrosis occurred; inhalation injury was rare but severe.

    Conclusions:

    • Prompt removal of clothing and immediate water lavage are essential for minimizing chemical injury.
    • Systemic toxicity and inhalation injury, though infrequent, significantly increase mortality risk in chemical burn patients.
    • Effective management involves addressing both local wound care and potential systemic complications.