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Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine® and treatment with calcium gluconate
This is a case report of decontamination and treatment of a 70% hydrofluoric acid (HF) dermal splash injury. A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved wa...
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Published in: | Journal of burn care & research 2011-07, Vol.32 (4), p.e149-e154 |
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container_title | Journal of burn care & research |
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creator | Yoshimura, Carlos Alberto Mathieu, Laurence Hall, Alan H Monteiro, Mário G Kool de Almeida, Décio Moreira |
description | This is a case report of decontamination and treatment of a 70% hydrofluoric acid (HF) dermal splash injury. A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. Even after a long delay, decontamination with Hexafluorine® appeared to be beneficial in this case. |
doi_str_mv | 10.1097/BCR.0b013e31822240f7 |
format | article |
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A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. 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A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. Even after a long delay, decontamination with Hexafluorine® appeared to be beneficial in this case.</description><subject>Accidents, Occupational</subject><subject>Adult</subject><subject>Burns, Chemical - pathology</subject><subject>Burns, Chemical - therapy</subject><subject>Calcium Gluconate - therapeutic use</subject><subject>Decontamination - methods</subject><subject>Emergency Treatment</subject><subject>Fluorine Compounds - therapeutic use</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Hydrofluoric Acid - adverse effects</subject><subject>Male</subject><subject>Metallurgy</subject><subject>Treatment Outcome</subject><issn>1559-047X</issn><issn>1559-0488</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNpdkMtOwzAURC0EoqXwBwh5xyrFr8QpO6h4SZWQeEjsIse-pkF5FNsBwkfxEXwZKS1dsJpZzJmrOwgdUjKmZCJPzqd3Y5ITyoHTlDEmiJVbaEjjeBIRkabbGy-fBmjP-xdChCAy3kUDRqWQnLMh-ryHN6hDhxfgsO4dnnfGNbZsG1dorHRhcN662p9iA6XqwPSqmzqoqqhVKJoavxdhjufwoVZQDd9fWNUGBwcqVMvK34RWpS7aCj-Xbc-rAPtox6rSw8FaR-jx8uJheh3Nbq9upmezSHOShCg1jMaMpDylhgoR5yZOjLGSaUWlJZOYJUwoxbnNRZJY0DzhucllTvofqbZ8hI5XvQvXvLbgQ1YVXkNZqhqa1mep7AsY4bxPilVSu8Z7BzZbuKJSrssoyZajZ_3o2f_Re-xofaDNKzAb6G9l_gMNFIF7</recordid><startdate>201107</startdate><enddate>201107</enddate><creator>Yoshimura, Carlos Alberto</creator><creator>Mathieu, Laurence</creator><creator>Hall, Alan H</creator><creator>Monteiro, Mário G Kool</creator><creator>de Almeida, Décio Moreira</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201107</creationdate><title>Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine® and treatment with calcium gluconate</title><author>Yoshimura, Carlos Alberto ; Mathieu, Laurence ; Hall, Alan H ; Monteiro, Mário G Kool ; de Almeida, Décio Moreira</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c306t-8d215208381d1445bd56ddf72ca17f0952624aa33fb466fec363bdb7b07471cf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Accidents, Occupational</topic><topic>Adult</topic><topic>Burns, Chemical - pathology</topic><topic>Burns, Chemical - therapy</topic><topic>Calcium Gluconate - therapeutic use</topic><topic>Decontamination - methods</topic><topic>Emergency Treatment</topic><topic>Fluorine Compounds - therapeutic use</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Hydrofluoric Acid - adverse effects</topic><topic>Male</topic><topic>Metallurgy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yoshimura, Carlos Alberto</creatorcontrib><creatorcontrib>Mathieu, Laurence</creatorcontrib><creatorcontrib>Hall, Alan H</creatorcontrib><creatorcontrib>Monteiro, Mário G Kool</creatorcontrib><creatorcontrib>de Almeida, Décio Moreira</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of burn care & research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yoshimura, Carlos Alberto</au><au>Mathieu, Laurence</au><au>Hall, Alan H</au><au>Monteiro, Mário G Kool</au><au>de Almeida, Décio Moreira</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine® and treatment with calcium gluconate</atitle><jtitle>Journal of burn care & research</jtitle><addtitle>J Burn Care Res</addtitle><date>2011-07</date><risdate>2011</risdate><volume>32</volume><issue>4</issue><spage>e149</spage><epage>e154</epage><pages>e149-e154</pages><issn>1559-047X</issn><eissn>1559-0488</eissn><abstract>This is a case report of decontamination and treatment of a 70% hydrofluoric acid (HF) dermal splash injury. A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. Even after a long delay, decontamination with Hexafluorine® appeared to be beneficial in this case.</abstract><cop>England</cop><pmid>21747332</pmid><doi>10.1097/BCR.0b013e31822240f7</doi></addata></record> |
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subjects | Accidents, Occupational Adult Burns, Chemical - pathology Burns, Chemical - therapy Calcium Gluconate - therapeutic use Decontamination - methods Emergency Treatment Fluorine Compounds - therapeutic use Follow-Up Studies Humans Hydrofluoric Acid - adverse effects Male Metallurgy Treatment Outcome |
title | Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine® and treatment with calcium gluconate |
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