Department of Plastic Surgery and Burns, Chemical Accident Rescue & Treatment Center, Jinshan Hospital, Fudan University, Jinshan District, Shanghai, PR China.
Burns. 2013 Nov;39(7):1468-73. doi: 10.1016/j.burns.2013.03.012. Epub 2013 Apr 24.
The epidemiological pattern of chemical burns varies widely in different areas of the world. To analyse effective preventive approaches, an insight into the pattern of injury is desirable. However, our data are only limited to Shanghai area, China.
A 10-year retrospective review includes all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2001 to December 2010; those who were admitted to the ophthalmologic department or other departments were excluded. The data collected included age, gender, injury pattern, patient workplaces, aetiological agents, incidence by month and year, burn size, burn depth and site, time for immediate irrigation, length of hospital stay and outcome.
A total of 615 patients admitted to our department for in-hospital treatment of chemical burn injury were included in the study. The mean age was 32.1±12.3 years with a range of 2-66 years. A total of 562 cases (91.4%) were male and 53 cases (8.6%) female. The mean total burn surface area (TBSA) was 30.3±24.7% with a mean full-thickness burn area of 17.5±23.8%. Most chemical burns took place in summer and fall. The majority of chemical burns were work related (93.0%); among them accidents that happened in private factories were predominant (70.8%). Although caustic soda was the leading cause of all chemical burns (15.8%), acid burn was the most common (45.2%). The extremities were the most frequent areas of injuries, followed by head and neck. Most cases had none (30.4%) or insufficient (61.1%) immediate irrigation after injury. In all patients, 47 cases had inhalation injuries, 94 cases accompanying ophthalmologic burns, 51 cases accompanying other associated injuries and 67 cases chemical toxicity. A total of 212 cases (34.5%) underwent early total or tangential excision and skin or skin flap grafting in the first week after injury. The mean length of hospital stay was 44.1±24.7 days. Sixteen cases died of respiratory failure, sepsis or multiple organ dysfunction syndrome (MODS), giving a mortality rate of 2.6%.
Safety training, preventive measures and following safety rules and strict regulation are of paramount importance for workers to prevent and reduce chemical burns in chemical enterprises, especially in private factories. Appropriate first-aid training that includes copious spot lavage should be emphasised. Eschar excision as early as possible and skin or skin flap grafting in deep wounds could reduce the possibility of poisoning and disability.
化学烧伤的流行病学模式在世界不同地区差异很大。为了分析有效的预防方法，了解损伤模式是可取的。然而，我们的数据仅限于中国上海地区。
回顾性分析 2001 年 1 月至 2010 年 12 月期间在烧伤整形科住院治疗的化学烧伤患者的临床资料。排除了在眼科或其他科室就诊的患者。收集的数据包括年龄、性别、损伤类型、患者工作场所、病因、月份和年份的发病率、烧伤面积、烧伤深度和部位、伤后即刻冲洗时间、住院时间和转归。
共 615 例化学烧伤患者纳入研究。平均年龄 32.1±12.3 岁，年龄范围 2-66 岁。其中 562 例（91.4%）为男性，53 例（8.6%）为女性。总烧伤面积（TBSA）平均为 30.3±24.7%，全厚烧伤面积平均为 17.5±23.8%。大多数化学烧伤发生在夏季和秋季。大多数化学烧伤与工作有关（93.0%）；其中以私营工厂事故为主（70.8%）。尽管苛性钠是所有化学烧伤的主要原因（15.8%），但酸烧伤最为常见（45.2%）。四肢是最常见的受伤部位，其次是头颈部。大多数患者在受伤后没有（30.4%）或仅有不足（61.1%）的即刻冲洗。所有患者中，47 例有吸入性损伤，94 例伴有眼科烧伤，51 例伴有其他合并损伤，67 例有化学中毒。共有 212 例（34.5%）在伤后第一周内进行了早期的全部或部分切除及皮肤或皮瓣移植。平均住院时间为 44.1±24.7 天。16 例患者因呼吸衰竭、脓毒症或多器官功能障碍综合征（MODS）死亡，死亡率为 2.6%。
对于化工企业，特别是私营企业的工人，安全培训、预防措施以及遵守安全规则和严格规定对于预防和减少化学烧伤至关重要。应强调适当的急救培训，包括大量局部冲洗。尽早切除焦痂和深创面植皮可降低中毒和致残的可能性。
