Chou T D, Lee T W, Chen S L, Tung Y M, Dai N T, Chen S G, Lee C H, Chen T M, Wang H J
Division of Plastic Surgery, Tri-Service General Hospital, 3F, 38-10, Sec. 3 Ting-Chow Road, National Defense Medical Center, 100, Taipei, Taiwan, ROC.
Burns. 2001 Aug;27(5):492-7. doi: 10.1016/s0305-4179(01)00003-1.
Phosphorus burns are a rarely encountered chemical burn, typically occurring in battle, industrial accidents, or from fireworks. Death may result even with minimal burn areas. Early recognition of affected areas and adequate resuscitation is crucial. Amongst our 2765 admissions between 1984 and 1998, 326 patients had chemical burns. Seven admissions were the result of phosphorus burns. Our treatment protocol comprises 1% copper sulfate solution for neutralization and identification of phosphorus particles, copious normal saline irrigation, keeping wounds moist with saline-soaked thick pads even during transportation, prompt debridement of affected areas, porcine skin coverage or skin grafts for acute wound management, as well as intensive monitoring of electrolytes and cardiac function in our burns center. Intravenous calcium gluconate is mandatory for correction of hypocalcemia. Of the seven, one patient died from inhalation injury and the others were scheduled for sequential surgical procedures for functional and cosmetic recovery. Cooling affected areas with tap water or normal saline, prompt removal of phosphorus particles with mechanical debridement, intensive monitoring, and maintenance of electrolyte balance are critical steps in initial management. Fluid resuscitation can be adjusted according to urine output. Early excision and skin autografts summarize our phosphorus burn treatment protocol.
磷烧伤是一种罕见的化学烧伤，通常发生在战斗、工业事故或烟花事故中。即使烧伤面积很小也可能导致死亡。早期识别受影响区域并进行充分的复苏至关重要。在我们1984年至1998年期间收治的2765例患者中，有326例为化学烧伤。其中7例是磷烧伤所致。我们的治疗方案包括用1%硫酸铜溶液中和并识别磷颗粒、大量生理盐水冲洗、即使在转运过程中也用浸有盐水的厚纱布保持伤口湿润、及时清创受影响区域、用猪皮覆盖或进行皮肤移植以处理急性伤口，以及在我们的烧伤中心对电解质和心功能进行密切监测。静脉注射葡萄糖酸钙对于纠正低钙血症是必需的。在这7例患者中，1例因吸入性损伤死亡，其他患者计划进行序贯外科手术以实现功能和外观恢复。用自来水或生理盐水冷却受影响区域、通过机械清创及时清除磷颗粒、密切监测以及维持电解质平衡是初始处理的关键步骤。液体复苏可根据尿量进行调整。早期切除和自体皮肤移植总结了我们的磷烧伤治疗方案。
