Nnabuko R E E, Okoye C P, Ogbonnaya I S, Isiwele Egi
Burns and Plastic Department, National Orthopaedic Hospital, PMB 01294 Enugu, Nigeria.
Department of Surgery, University of Calabar Teaching Hospital, Calabar, Nigeria.
Burns Trauma. 2017 Mar 7;5:7. doi: 10.1186/s41038-017-0072-1. eCollection 2017.
Burns present a devastating injury to patients. Burns caused by chemical agents, present a worse scenario. In a resource limited country like Nigeria, readily available sources of these corrosive agents are mainly from lead-acid battery vendors and to some extent local small scale soap manufacturers who use caustic soda. We hypothesized that with the reduction in small scale soap manufacturing and increasing trend towards modernization in the use of dry cell batteries, chemical burns may be on the decline, and we sought to investigate this.
The records of all acute burn patients seen at the Burns and Plastic Department of the National Orthopaedic Hospital Enugu Nigeria between January 2011 and December 2014 were retrospectively reviewed. The results were compared to similar studies carried out at the same centre. A questionnaire was administered to corrosive chemical (sulphuric and caustic soda) vendors to assess the trends in product sales and use in recent times.
A total of 624 acute burn cases were treated during the period; among which, 12 cases (1.9%) were chemical burns. When compared with previous studies at the centre, Chemical burn cases were recorded as the lowest rate. The median age of patients was 24 years. There were eight males and four females. Interpersonal assault was the commonest mechanism of injury with sulphuric acid suspected to be the commonest agent in 83.3% of the cases, while 16.7% of the cases were from accidental use of caustic soda. The head and neck as well as the upper limbs were the most affected (30%). Twenty-six questionnaires to lead-acid vendors were analyzed and revealed that all respondents noticed a marked downward trend in the sale of either sulphuric acid or caustic soda, and they attributed this to the ready availability of imported alternatives to locally manufactured soap or wet lead-acid batteries. Ease of use, durability and convenience of the dry cell batteries were cited as principal reasons.
There appears to be a downward trend in the prevalence of chemical burns in our study compared to previous studies in the centre which may be due to reduced availability and access of corrosive chemicals to the general public. Further prospective multicentre studies to confirm this are recommended.
烧伤对患者来说是一种毁灭性的伤害。化学制剂导致的烧伤情况更糟。在像尼日利亚这样资源有限的国家，这些腐蚀性制剂的常见来源主要是铅酸电池供应商，在一定程度上还有使用苛性钠的当地小型肥皂制造商。我们推测，随着小型肥皂制造业的减少以及干电池使用的现代化趋势增加，化学烧伤可能会呈下降趋势，我们试图对此进行调查。
回顾性分析2011年1月至2014年12月期间在尼日利亚埃努古国家骨科医院烧伤与整形科就诊的所有急性烧伤患者的记录。将结果与在同一中心进行的类似研究进行比较。向腐蚀性化学制剂（硫酸和苛性钠）供应商发放问卷，以评估近期产品销售和使用的趋势。
在此期间共治疗了624例急性烧伤病例；其中12例（1.9%）为化学烧伤。与该中心之前的研究相比，化学烧伤病例记录为最低比例。患者的中位年龄为24岁。有8名男性和4名女性。人际攻击是最常见的受伤机制，83.3%的病例中硫酸被怀疑是最常见的制剂，而16.7%的病例是由于意外使用苛性钠。头部、颈部以及上肢受影响最大（30%）。对26份发给铅酸电池供应商的问卷进行了分析，结果显示所有受访者都注意到硫酸或苛性钠的销售量有明显下降趋势，他们将此归因于进口替代品可方便地替代本地生产的肥皂或湿式铅酸电池。干电池的易用性、耐用性和便利性被列为主要原因。
与该中心之前的研究相比，我们的研究中化学烧伤的患病率似乎呈下降趋势，这可能是由于腐蚀性化学制剂对公众的可获得性和接触机会减少。建议进行进一步的前瞻性多中心研究以证实这一点。
