Treatment for Hydrofluoric Acid Chemical Burn Using Acticoat®

Acticoat®를 이용한 불산에 의한 화학 화상의 치료

  • Choi, Hwan Jun (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University) ;
  • Wee, Syeo Young (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University) ;
  • Choi, Chang Yong (Department of Plastic and Reconstructive Surgery, College of Medicine, Soon Chun Hyang University)
  • 최환준 (순천향대학교 의과대학 성형외과학교실) ;
  • 위서영 (순천향대학교 의과대학 성형외과학교실) ;
  • 최창용 (순천향대학교 의과대학 성형외과학교실)
  • Received : 2007.12.31
  • Accepted : 2008.04.08
  • Published : 2008.07.10

Abstract

Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with the dissociated fluoride ions. The initial corrosive burn is caused by free hydrogen ion, and the second and more severe burn is caused by penetration of fluoride ions into subcutaneous tissues. Silver is a cation producing dressing, an effective antimicrobial agent, but older silver-containing formulations are rapidly inactivated by wound environment, requiring frequent replenishment. But, $Acticoat^{(R)}$ is a relatively new form of silver dressing which helps avoid the problems of earlier agents. The aim of this study is to evaluate effects of $Acticoat^{(R)}$, silver-containing dressing on the treatment for HF injury wound. Methods: From september 2006 to september 2007, the study was carried out with 10 patients who had HF partial thickness burns. $Acticoat^{(R)}$ dressing and 10% calcium gluconate wet gauze dressings in 10 cases. As a principle, in the emergency treatment, partial or complete removal of the nail and early bullectomy along with copious washing with normal saline was done, depending on the degree of HF invasion of the wound. Wound was dressed with $Acticoat^{(R)}$ and 10% calcium gluconate solution. The effect of dressing was investgated by serial bacterial culture and wound exudates assessment. Results: We therefore reviewed 10 cases of HF-induced chemical burns and treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increased incidences of HF-induced chemical burns. The education of patients regarding this subject should be empathized accordingly. In conclusion, $Acticoat^{(R)}$ dressing is a better choice for HF partial thickness burn injuries because of shorter healing time, less pain and more comfortable dressing.

Keywords

References

  1. Nam SM, Choi HJ, Kim MS: Treatment for hydrofluoric acid chemical injury on hands. J Korean Soc Plast Reconstr Surg 34: 470, 2007
  2. Shewmake SW, Anderson BG: Hydrofluoric acid burns. A report of a case and review of the literature. Arch Dermatol 115: 593, 1979 https://doi.org/10.1001/archderm.115.5.593
  3. Chick LR, Borah G: Calcium carbonate gel therapy for hydrofluoric acid burns of the hand. Plast Reconstr Surg 86: 935, 1990 https://doi.org/10.1097/00006534-199011000-00016
  4. Anderson WJ, Anderson JR: Hydrofluoric acid burns of the hand: mechanism of injury and treatment. J Hand Surg (Am) 13: 52, 1988 https://doi.org/10.1016/0363-5023(88)90200-6
  5. Dibbell DG, Iverson RE, Jones W, Laub DR, Madison MS: Hydrofluoric acid burns of the hand. J Bone Joint Surg Am 52: 931, 1970 https://doi.org/10.2106/00004623-197052050-00008
  6. Wedler V, Guggenheim M, Moron M, Kunzj W, Meyer VE: Extensive hydrofluoric acid injuries: a serious problem. J Trauma 58: 852, 2005 https://doi.org/10.1097/01.TA.0000114528.15627.65
  7. Roblin I, Urban M, Flicoteau D, Martin C, Pradeau D: Topical treatment of experimental hydrofluoric acid skin burns by 2.5% calcium gluconate. J Burn Care Res 27: 889, 2006 https://doi.org/10.1097/01.BCR.0000245767.54278.09
  8. Jeong TK, Yang HJ: Effectiveness of nanocrystalline silver dressing at wound infected by multidrug resistant bacteria. J Korean Soc Plast Reconstr Surg 34: 691, 2007
  9. Park JH, Na YC, Cho KS, Yu SJ, Ahn HC: Efficacy of Aquacel$^{\circledR}$ dressing in partial thickness burn patients. J Korean Soc Plast Reconstr Surg 32: 491, 2005
  10. Lee JH, Lee ES, Kang SR: Role of silver-containing carboxymethyl cellulose dressing in the management of exudative infected wounds. J Korean Soc Plast Reconstr Surg 34: 305, 2007
  11. Gok NS, Kim HK, Kim SH, Kim WS, Bae TH, Kim MK: Comparative study of Acticoat$^{\circledR}$ & Allevyn$^{\circledR}$ on infected full-thickness wound of the rat skin. J Korean Soc Plast Reconstr Surg 34: 169, 2007