title: Management of acid burns: experience from Bangladesh.
abstract: Acid burn injuries in Bangladesh primarily occur as a result of intentional attacks although there are incidences of accidental acid burns in industry, on the street, and at home. A total of 126 patients with acid burns, 95 from attacks and 31 from accidents, were studied from July 2004 to December 2012. A diagnosis of acid burn was made from history, physical examination and in some cases from chemical analysis of the patients' clothing. Alkali burns were excluded from the study. In the burn unit of Dhaka Medical College Hospital, we applied a slightly different protocol for management of acid burns, beginning with plain water irrigation of the wound, which effectively reduced burn depth and the requirement of surgical treatment. Application of hydrocolloid dressing for 48-72 h helped with the assessment of depth and the course of treatment. Early excision and grafting gives good results but resultant acid trickling creates a marble cake-like appearance of the wound separated by the vital skin. Excision with a scalpel and direct stitching of the wounds are often a good option. Observation of patients on follow-up revealed that wounds showed a tendency for hypertrophy. Application of pressure garments and other scar treatments were given in all cases unless the burn was highly superficial.
authors.affiliation: Burn and Plastic Surgery Unit, Dhaka Medical College Hospital, Dhaka, Bangladesh. Electronic address: kishorek50@hotmail.com.
authors.forename: Kishore Kumar
authors.initials: KK
authors.lastname: Das
authors.affiliation: Wolfson Medical Center, Holon, Israel.
authors.forename: Loren
authors.initials: L
authors.lastname: Olga
authors.affiliation: The Arizona Burn Center, USA; Maricopa Medical Center, Phoenix, AZ, USA; College of Medicine, USA; Division of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona Health Sciences Center, Tucson, AZ, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Peck
authors.affiliation: Università di Bologna-Alma Mater Studiorum, Italy.
authors.forename: Paolo G
authors.initials: PG
authors.lastname: Morselli
authors.affiliation: Burn and Plastic Surgery Unit, Dhaka Medical College Hospital, Dhaka, Bangladesh.
authors.forename: A J M
authors.initials: AJ
authors.lastname: Salek
mesh_terms: D000059:Accidents / Q000706:statistics & numerical data*; D000143:Acids; D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D047070:Bandages, Hydrocolloid; D001459:Bangladesh / Q000453:epidemiology; D002057:Burns, Chemical / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D015331:Cohort Studies; D058128:Compression Bandages; D019548:Crime Victims / Q000706:statistics & numerical data; D019468:Disease Management; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016038:Skin Transplantation; D016896:Treatment Outcome; D014754:Violence / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D000143:Acids
keywords: Acid burn; Acid burn assessment; Acid burn treatment; Chemical burn