Hydrofluoric Acid Burns: A 15-Year Experience

Stuke, Lance; Arnoldo, Brett D.; Hunt, John L.; Purdue, Gary F.

doi:10.1097/bcr.0b013e31818b9de6

Cited by 53 publications

(24 citation statements)

References 7 publications

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“…However, when burns involving the hands and arms were assessed together, the upper extremities (37.36%) were also the most common site of HF injury (Fig. 4), which parallels the results reported by Hatzifotis et al [3] and Stuke et al [17]. These authors assessed cases of patients with chemical burns, where most of the injuries involving the extremities could be prevented, once again emphasising the importance of correct occupational training, management and protection upon exposure to dangerous chemicals.…”

Section: Discussionsupporting

confidence: 88%

“…These authors assessed cases of patients with chemical burns, where most of the injuries involving the extremities could be prevented, once again emphasising the importance of correct occupational training, management and protection upon exposure to dangerous chemicals. In the study, by Hatzifotis et al [3] and Stuke et al [17], burns located on the head and neck were also usual; a result which also corresponded with the assessments of patients at our hospital department. Further analysis showed that burn injuries of this nature were caused by chemicals spilled or splashed from machines or pipes.…”

Section: Discussionsupporting

confidence: 86%

“…This demographic was seen to be affected most frequently [7, 16, 17]. More than 95% of individuals with chemical burns were between the ages of 20 and 59 years (Table 1).…”

Section: Discussionmentioning

confidence: 99%

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Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study

Zhang¹,

Zhang

Jiang

et al. 2016

J Occup Med Toxicol

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BackgroundChemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. This study aimed to investigate the epidemiological characteristics of HF burns within this region.MethodsA 10-year retrospective analysis was conducted using data from all inpatients with HF burns. These patients were treated at the Department of Burns and Plastic Surgery at our hospital between January 2004 and December 2013. Information obtained for each patient included sex, age, occupation, burn location, burn cause, and the hazard category of the chemical which caused the burn. Data regarding wound site and size, accompanying injuries, serum electrolyte levels, operations, length of hospital stay, and mortality were also assessed.ResultsA total of 201 patients (189 males, 12 females; average age: 38.33 ± 10.57 years) were admitted due to HF burns. Over the 10-year period, the morbidity of HF burns in the past 10 years showed a gradual increase, which paralleled the development of local fluoride industries. Most HF injuries were work related and distributed in working-age patients. Aqueous HF solutions, especially highly concentrated ones, were the most common chemical cause of HF burns. Moreover, inappropriate operation, machine problems, and inadequate protection were identified as the leading causes of HF burns in the workplace. The burn area was <5% of TBSA in more than 90% of patients, and the most common burn sites were the head, neck, and upper extremities. Approximately 17% of patients underwent surgical operation. Accompanying injuries should be detected and treated correctly in a timely manner. Lastly, electrolyte imbalances, such as hypocalcaemia, hypomagnesaemia, and hypokalaemia, occurred frequently in patients with HF exposure; however, hyperkalaemia was not encountered in this study.ConclusionBased on the epidemiological results for HF burns in this region, the related enterprises and local authorities should be encouraged to upgrade management policies and to provide necessary occupational hazard education and safety training for high-risk occupations within high-risk working populations. Furthermore, the enhancement of hazardous chemicals management is also needed. Finally, for patients with HF exposure, early and correct pre-hospital triage, treatment and consequent in-hospital treatment and procedures should also be improved.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 86%

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Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study

Zhang¹,

Zhang

Jiang

et al. 2016

J Occup Med Toxicol

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“…To effectively treat the patients with HF exposure, immediate specific and specialized medical measures seem to be essential. In addition to the traditional measures for chemical injuries, arterial infusion of calcium gluconate has been reported as an effective method to treat chemical burns occurring due to HF [5,6]. Herein, we report 118 cases of HF burns, who received intraarterial calcium gluconate treatment.…”

Section: Methods For Arterial Infusion Of Calcium Gluconatementioning

confidence: 99%

Clinical arterial infusion of calcium gluconate: The preferred method for treating hydrofluoric acid burns of distal human limbs

Zhang¹,

Ni²,

Wang³

et al. 2014

International Journal of Occupational Medicine and Environmental Health

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Objective: This study was designed to evaluate the efficiency and safety of arterial infusions of calcium gluconate to treat hydrofluoric (HF) acid burns of the distal human limbs. Materials and Methods: Eligible patients with HF burn limbs, collected from January 2008 to October 2011, were given the arterial infusion of calcium gluconate into the injured limbs. The measures of pain were conducted before the infusion, immediately after the infusion, 4 h after the infusion, and 2 days after the infusion by the visual analogy score (VAS). If the VAS score was higher than 4.0 at the time point 4 h after the first infusion, the infusion was repeated. The time of wound healing, and the number and ratio of the cases receiving the surgical operation were also evaluated. Results: A total of 118 patients, male (107 cases) and female (11 cases), were collected, including 64 cases of outpatients and 54 cases of inpatients. The age of the subjects ranged from 16 to 60 years, with the mean age of 37.6. The burn sites were located in the lateral limbs (28 cases) and in the unilateral limbs (90 cases). For 107 cases, the pain scores decreased quickly after the first infusion. The other 11 cases, with the VAS score higher than 4.0 at the time point 4 h after the first infusion, received the second infusion. The average time of wound healing and the ratio of the cases receiving the surgical operation were closely related to the interval from the injury to the reception of infusion. Conclusions: Arterial infusion of calcium gluconate, effectively relieving the pain, blocking wound progressive deepening, and causing no adverse effects, could be the preferential method to treat hydrofluoric acid burns of the distal human limbs.

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“…Hydrofluoric acid is a dangerous inorganic acid that is widely used in electronics manufacturing, glass etching, removal of rust, pest control in agriculture and heavy-duty domestic cleaning. 1 The fluoride ions in hydrofluoric acid are strong scavengers of bivalent cations, such as calcium and magnesium, and can slowly penetrate skin tissue, resulting in necrosis. Many workers using this acid may not be aware of the hazards and protective measures that are needed.…”

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confidence: 99%