Cartotto R C, Peters W J, Neligan P C, Douglas L G, Beeston J
Burn Unit, Hotel Dieu Hospital, Kingston, Ont.
Can J Surg. 1996 Jun;39(3):205-11.
To report a burn unit's experience with chemical burns and to discuss the fundamental principles in managing chemical burns.
A chart review.
A burn centre at a major university-affiliated hospital.
Twenty-four patients with chemical burns, representing 2.6% of all burn admissions over an 8-year period at the Ross Tilley Regional Adult Burn Centre. Seventy-five percent of the burn injuries were work-related accidents. Chemicals involved included hydrofluoric acid, sulfuric acid, black liquor, various lyes, potassium permanganate and phenol.
Fourteen patients required excision and skin grafting. Complications were frequent and included ocular chemical contacts, wound infections, tendon exposures, toe amputation and systemic reactions from absorption of chemical. One patient died from a chemical scald burn to 98% of the body surface area.
The key principles in the management of chemical burns include removal of the chemical, copious irrigation, limited use of antidotes, correct estimation of the extent of injury, identification of systemic toxicity, treatment of ocular contacts and management of chemical inhalation injury. Individualized treatment is emphasized.
报告一家烧伤科处理化学烧伤的经验，并探讨化学烧伤处理的基本原则。
病历回顾。
一所大型大学附属医院的烧伤中心。
24例化学烧伤患者，占罗斯·蒂利地区成人烧伤中心8年期间所有烧伤入院患者的2.6%。75%的烧伤是工伤事故。涉及的化学物质包括氢氟酸、硫酸、黑液、各种碱液、高锰酸钾和苯酚。
14例患者需要进行切除和植皮手术。并发症很常见，包括眼部化学物质接触、伤口感染、肌腱外露、脚趾截肢以及化学物质吸收引起的全身反应。1例患者因化学烫伤导致98%的体表面积烧伤而死亡。
化学烧伤处理的关键原则包括去除化学物质、大量冲洗、有限使用解毒剂、正确估计损伤范围、识别全身毒性、处理眼部接触以及处理化学吸入性损伤。强调个体化治疗。
