Orcutt T J, Pruitt B A
Major Probl Clin Surg. 1976;19:84-95.
The prompt recognition and management (Tables 8-1 and 8-2) of chemical burns of the upper extremity may prevent injury to the deep structures of the hand and may make the difference between satisfactory rehabilitation and crippling deformities. Immediate irrigation with water is the single most important treatment that can be carried out, and should be continued for at least an hour and often for several hours, depending on the severity of the injury. Precious time should not be wasted hunting for a specific neutralizing agent. Hydrofluoric acid injuries and phosphorus injuries are the two exceptions to this principle. After copious irrigation and débridement, small superficial burns may be treated without dressings or topical therapy. Large partial-thickness burns are best treated with Sulfamylon burn cream and then with with biologic dressings until healing is achieved. Full-thickness injuries of limited extent should be excised and skin-grafted to regain maximum function, and more extensive burns treated in a nonexicisional regimen.
上肢化学烧伤的及时识别与处理（表8 - 1和8 - 2）可防止手部深层结构受损，并可能决定康复效果是令人满意还是导致致残性畸形。立即用水冲洗是最重要的单项治疗措施，应持续冲洗至少1小时，通常需冲洗数小时，具体时长取决于损伤的严重程度。不应浪费宝贵时间去寻找特定的中和剂。氢氟酸损伤和磷烧伤是该原则的两个例外情况。大量冲洗和清创后，小面积浅度烧伤可不使用敷料或局部治疗。大面积深Ⅱ度烧伤最好先用磺胺嘧啶银乳膏治疗，然后用生物敷料，直至伤口愈合。局限性全层损伤应进行切除并植皮以恢复最大功能，更广泛的烧伤则采用非切除治疗方案。
