How Do I Treat a Chemical Burn?

The degree of damage from chemical burns is closely related to the nature, dose, concentration, physical state (solid, liquid, gaseous) of the chemical, the size of the contact time and the contact area, and the emergency measures at the time. Chemicals have a local damage effect, mainly dehydration and protein degeneration of cells, and some produce heat and aggravate burns. Chemical burns are different from general thermal burns. The contact factors between chemical burns and the skin are often longer than thermal burns. Therefore, some chemical burns can be localized, deep, progressive damage, or even absorbed through wounds and other means. Damage to various organs throughout the body.

Basic Information

English name: chemical burn
Visiting department: Burn Plastic Surgery

Common causes: Contact with a series of chemicals such as strong acid, strong base, phosphorus, etc.
Common symptoms: The pain is more severe, it can dehydrate the tissues without forming blisters, and leather-like crusts, etc.

Causes of chemical burns

Caused by contact with a series of chemicals such as strong acids, strong bases, and phosphorus.

Clinical manifestations of chemical burns

Chemical burns are often accompanied by chemical poisoning: chemical burns in small and medium areas can cause patient death, mainly due to poisoning, such as yellow phosphorus burns. Because various chemical agents are different, absorption, storage, and excretion in the body are also different, but most are detoxified by the liver and excreted by the kidney. Therefore, liver and kidney damage are more common clinically.

Chemical vapor or smoke can directly stimulate the respiratory tract and cause respiratory tract burns: Many volatile chemical drugs are discharged from the respiratory tract, so chemical burns with respiratory tract burns or respiratory complications (pulmonary edema, bronchial pneumonia, etc.) are not uncommon.

Acid burn

The more common acid burns are strong acids (sulfuric acid, hydrochloric acid, nitric acid). Its common features are coagulation and necrosis of tissue proteins, dehydration of tissues, no blisters, and leather-like scabs, which generally do not invade into the depths, but the time to release is delayed.

2. Alkali burns

Strong bases such as sodium hydroxide and potassium hydroxide can also dehydrate tissues, but after combining with tissue proteins to form a complex, they can saponify adipose tissue. It can generate heat during saponification, continue to damage the tissue, and alkali ions can penetrate deep. The pain is more severe, the wound can be enlarged and deepened, and healing is slow.

3. Phosphorus burn

Phosphorus burns are characteristic chemical burns. Phosphorus spontaneously ignites upon contact with air, and a blue-green flame can be seen in a dark environment. Phosphorus is a cytoplasmic poison that can cause liver, kidney, heart, lung and other organ damage after absorption.

Chemical burn check

Same as thermal burns. If necessary, the blood content of toxic chemicals should be determined.

Differential diagnosis of chemical burns

It is mainly distinguished from radioactive burns and fire burns. Medical history can be identified with or without chemical exposure.

Chemical burn treatment

First aid treatment of chemical burns:

1. Quickly get rid of pollutants, and immediately rinse with flowing cold water for more than 20-30 minutes. Sometimes the chemicals on the wound surface (such as dry lime powder) should be wiped off first, and then washed with flowing water to avoid generating a lot of heat after contact with water, causing further damage to the wound, such as thermal burns. After rinsing, you can use the corresponding neutralizer, the neutralization time is not too long, and then rinse with running water after a while.

2. Confirm in time whether there is chemical poisoning, and treat it in a timely manner according to its treatment principles. If a detoxification agent or a certain poison is not available for a while, you can use a large amount of hypertonic glucose and vitamin C intravenous infusion, give oxygen, transfusion of fresh blood, etc. If there is no contraindication, apply diuretics early, and then choose detoxification according to the situation Agent.

3. Burn virus: Shock resuscitation and wound treatment according to the treatment method of burn. Early excision of degree eschar and elimination of deep degree wound necrosis tissue to cut off the source of poison.

4. Handle comorbidities and complications in a timely manner, and if necessary, ask relevant departments to assist in diagnosis and treatment.

In short, the chemical burn treatment principles are the same as ordinary burns. It should be quickly removed from the scene to stop the continued damage of the body by chemical substances; take effective detoxification measures to prevent poisoning; and conduct comprehensive medical and chemical tests.