Chemical injuries: the Tasmanian Burns Unit experience.
BACKGROUND
Chemical burns account for relatively few admissions to a burns unit. These injuries, however, deserve separate consideration because of their ability to cause continuing tissue destruction, their potential to cause systemic toxicity and the value of early treatment with copious lavage. Widespread inexperience in the treatment of chemical burns highlights the potential for greater levels of general awareness and knowledge.


METHODS
A review of 31 patients with chemical injuries admitted to the Tasmanian Burns Unit at the Royal Hobart Hospital (RHH) was carried out for the years 1989-1999.


RESULTS
The majority of patients were men aged 20-49 years (mean age: 32 years). Fifty-one per cent of injuries occurred in a domestic and 38% in an industrial setting. The more common aetiological agents were cement (25%), sulphuric acid (16%) and hydrofluoric acid (16%). The upper and lower extremities were involved in all but four patients and the mean total body surface area affected was 3.4%. The mean length of hospital stay was 9 days with a range of 1-30 days. Management of injuries consisted of either surgical or conservative treatment. The former included debridement and split-thickness skin grafting or primary closure and the latter of topical treatment with 1% silver sulfadiazine cream and appropriate dressings.


CONCLUSIONS
Widespread inexperience in the treatment of chemical injuries highlights the potential for greater levels of knowledge. This is particularly apparent in the early management of these injuries.
Ricketts
Sophie
S
Tasmanian Burns Unit, Royal Hobart Hospital, Hobart, Tasmania 7000, Australia.
Kimble
Francis W
FW
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001830:Body Surface Area; D002053:Burn Units; D002057:Burns, Chemical / Q000453:epidemiology / Q000209:etiology / Q000628:therapy; D002424:Caustics / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003252:Construction Materials / Q000009:adverse effects; D003646:Debridement; D005260:Female; D006230:Hand Injuries / Q000139:chemically induced; D006801:Humans; D006858:Hydrofluoric Acid / Q000009:adverse effects; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016038:Skin Transplantation; D013464:Sulfuric Acids / Q000009:adverse effects; D013648:Tasmania / Q000453:epidemiology
D002424:Caustics; D013464:Sulfuric Acids; C033158:sulfuric acid; D006858:Hydrofluoric Acid