University of Western Australia, Burn Injury Research Unit, School of Biomedical Sciences, 35 Stirling Highway, Crawley, Western Australia, 6009, Australia.
School of Nursing, University of Tasmania, Rozelle Campus, Sydney, NSW, Australia; National Burns Center, Sheba Medical Center, Israel.
Burns. 2022 Nov;48(7):1527-1543. doi: 10.1016/j.burns.2022.05.006. Epub 2022 May 14.
Chemical burns can cause deep injury and subsequently significant scarring to the skin. The mechanism and pathophysiology of chemical burns is distinct to thermal burns, and recommended first aid approaches are consequently different. Twenty minutes of cool running water is an effective first aid measure to improve outcomes after thermal burn. For chemical burns to the skin, the recommendations are immediate water lavage for 60 min, removal of contaminated clothing if not stuck to the skin and then covering the wound with a sterile dressing. This review assesses the peer-reviewed literature to find the evidence behind the efficacy of cutaneous chemical burn first aid on short term outcomes such as length of hospital stay, depth of burn and longer-term outcomes such as scarring; in particular, the effect of immediate or early water lavage, and the effect of the duration of water lavage. Ocular chemical burns were not included in this review. The review suggests some evidence to support that the early application of cool water irrigation may reduce length of hospital stay and the extent of scarring. Community education should emphasize that water irrigation is recommended and that the earlier this happens, the better.
化学烧伤可导致皮肤深度损伤，并随后产生显著的瘢痕。化学烧伤的发生机制和病理生理学与热烧伤不同，因此推荐的急救方法也不同。20 分钟的冷流水冲洗是一种有效的急救措施，可以改善热烧伤的预后。对于皮肤化学烧伤，建议立即用流水冲洗 60 分钟，如果衣服没有粘在皮肤上，应将其去除，并使用无菌敷料覆盖伤口。本综述评估了同行评议文献，以寻找皮肤化学烧伤急救在短期预后（如住院时间、烧伤深度）和长期预后（如瘢痕形成）方面的疗效的证据；特别是立即或早期流水冲洗的效果，以及流水冲洗持续时间的效果。本综述未包括眼部化学烧伤。该综述表明，有一些证据支持早期应用冷水冲洗可能会减少住院时间和瘢痕形成的程度。社区教育应强调推荐使用流水冲洗，而且冲洗时间越早越好。
