Ruhl C M, Park S J, Danisa O, Morgan R F, Papirmeister B, Sidell F R, Edlich R F, Anthony L S, Himel H N
Department of Plastic Surgery, University of Virginia School of Medicine, Charlottesville 22908.
J Emerg Med. 1994 Mar-Apr;12(2):159-66. doi: 10.1016/0736-4679(94)90693-9.
Despite the Geneva Protocol of 1925 and the Paris Conference on Prohibition of Chemical Weapons in 1989, sulfur mustard and other chemical weapons continue to pose a hazard to both civilians and soldiers. The presence of artillery shells containing sulfur mustard, both in waters where these shells were dumped and in old battlefields, presents a problem in times of peace, especially for those who collect wartime memorabilia. Past literature has reported several hundred incidents involving fishermen who inadvertently pulled leaking shells aboard their fishing vessels, thereby exposing themselves to the vesicant chemical. Other literature reports exposure to children who found the chemical shells in old battlefields. The purpose of this article is to report the first case of a serious sulfur mustard burn that occurred after removing the detonator from an old artillery shell in a historic battle field near Verdun, France. The circumstances surrounding the injury, the diagnosis and management of injuries secondary to sulfur mustard, and the long-term consequences to the patient are presented and discussed. Although skin grafting has been used in the management of other chemical burn injuries, this report is the first to describe the need for split-thickness skin grafts in the management of a patient with sulfur mustard burns.
尽管有1925年的《日内瓦议定书》以及1989年的巴黎禁止化学武器会议，但芥子气和其他化学武器仍然对平民和士兵构成威胁。装有芥子气的炮弹存在于炮弹被倾倒的水域以及旧战场上，在和平时期造成了问题，尤其是对于那些收集战时纪念品的人来说。过去的文献报道了数百起事件，涉及渔民无意中将泄漏的炮弹拖上他们的渔船，从而使自己暴露于这种糜烂性化学物质中。其他文献报道了儿童在旧战场上发现化学炮弹而接触到这种物质的情况。本文的目的是报告第一例严重的芥子气烧伤病例，该病例发生在法国凡尔登附近的一个历史战场上，伤者从一枚旧炮弹上拆除雷管之后。文中介绍并讨论了受伤的相关情况、芥子气所致损伤的诊断和处理，以及对患者的长期影响。虽然皮肤移植已被用于其他化学烧伤的治疗，但本报告首次描述了在芥子气烧伤患者的治疗中需要使用中厚皮片移植。
