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化学烧伤:病理生理学与治疗方案——颈部面部损伤是否带来特殊挑战?

Chemical burns: pathophysiology and therapeutic protocols-do cervico-facial injuries pose specific challenges?

作者信息

Giurgiu Rares-Adrian, Dumitru Catalina-Stefania, Grosu-Bularda Andreea, Bordeanu-Diaconescu Eliza-Maria, Frunza Adrian, Grama Sabina, Hodea Florin-Vlad, Neagu Tiberiu-Paul, Lascar Ioan, Hariga Cristian-Sorin

机构信息

Department of Plastic Surgery and Reconstructive Microsurgery, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.

Burn Centre, Emergency Clinical Hospital of Bucharest, Bucharest, Romania.

出版信息

J Med Life. 2025 May;18(5):440-448. doi: 10.25122/jml-2025-0082.

Abstract

Chemical burns, though relatively rare, present significant diagnostic and therapeutic challenges due to their complex pathophysiology and the need for specialized care. A retrospective study was conducted, examining the characteristics, treatment, and outcomes of 33 patients with chemical burns admitted to our burn center for 8 years, representing 4.39% of all burn cases. Among them, 15 patients (45.45%) had chemical burns on the face and neck. The majority of these patients were men, with a relatively younger average age, and a significant proportion had work-related accidents. The burned surface area was variable, with many patients sustaining small total body surface area (TBSA), although some presented with extensive involvement. The prevalence of superficial partial-thickness burns was higher, but deep partial-thickness and full-thickness burns were also common. A large proportion of patients had favorable Abbreviated Burn Severity Index (ABSI) scores, indicating a high probability of survival. However, ocular involvement was a major complication. The study emphasizes the importance of timely intervention, including appropriate wound management strategies, specialized dressings, and skin substitutes. The findings also stress the need for a multidisciplinary approach, close monitoring, and adherence to safety protocols to optimize outcomes and minimize long-term complications in patients with chemical burns, particularly those of the face and neck region.

摘要

化学烧伤虽然相对少见,但因其复杂的病理生理过程以及对专科护理的需求,在诊断和治疗方面存在重大挑战。我们进行了一项回顾性研究,调查了8年间收治于我院烧伤中心的33例化学烧伤患者的特征、治疗方法及治疗结果,这些患者占所有烧伤病例的4.39%。其中,15例患者(45.45%)面部和颈部有化学烧伤。这些患者中大多数为男性,平均年龄相对较小,且相当一部分患者发生了与工作相关的事故。烧伤表面积各不相同,许多患者的总体表面积(TBSA)较小,不过也有一些患者烧伤范围广泛。浅表部分厚度烧伤的发生率较高,但深部部分厚度烧伤和全层烧伤也很常见。大部分患者的简化烧伤严重程度指数(ABSI)评分良好,表明存活概率较高。然而,眼部受累是主要并发症。该研究强调了及时干预的重要性,包括适当的伤口处理策略、专用敷料和皮肤替代物。研究结果还强调,对于化学烧伤患者,尤其是面部和颈部区域的患者,需要采取多学科方法、密切监测并遵守安全协议,以优化治疗结果并将长期并发症降至最低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/56bf/12207703/9b3da9e9e05c/JMedLife-18-440-g001.jpg

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