title: Caustic burn caused by intradermal self administration of muriatic acid for suicidal attempt: optimal wound healing and functional recovery with a non surgical treatment.
abstract: BACKGROUND
  Caustic burns are burns of third and fourth degree caused by strong acids or strong bases. Muriatic acid is often used for suicidal attempt by ingestion. We describe a case of a caustic skin lesion caused by intravenous failed attempt of suicide by injection of Muriatic acid in a woman affected with bipolar-syndrome. Generally, caustic burns are treated by cleansing, escarectomy and coverage with skin grafts.
  
  
  METHODS
  We treated the patient with a non invasive technique with collagenase and hyaluronic acid sodium salt cream (Bionect start®), hyaluronic acid-based matrix (Hyalomatrix®) and Vacuum-Assisted Closure (VAC) Therapy®.
  
  
  RESULTS
  We obtained complete healing in 6 weeks.
  
  
  CONCLUSIONS
  Combined use of non invasive techniques seems to ensure only advantages for both the patients and the Health System. It reduces health care costs and risks for the patients such as nosocomial infections. Patient's compliance is high, as its quality of life. Complete healing of the wound is fast and recovery of function is full.
authors.forename: P
authors.initials: P
authors.lastname: Fino
authors.forename: A M
authors.initials: AM
authors.lastname: Spagnoli
authors.forename: M
authors.initials: M
authors.lastname: Ruggieri
authors.forename: M G
authors.initials: MG
authors.lastname: Onesti
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001714:Bipolar Disorder / Q000523:psychology; D002057:Burns, Chemical / Q000209:etiology* / Q000628:therapy*; D017364:Collagenases / Q000008:administration & dosage*; D003879:Dermatologic Agents / Q000008:administration & dosage*; D062109:Dermatologic Surgical Procedures; D004338:Drug Combinations; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage*; D006851:Hydrochloric Acid / Q000008:administration & dosage / Q000009:adverse effects*; D007271:Injections, Intradermal; D054843:Negative-Pressure Wound Therapy / Q000379:methods; D012646:Self Administration; D063465:Skin Cream / Q000008:administration & dosage; D013406:Suicide, Attempted / Q000523:psychology; D014945:Wound Healing
chemical_list: D003879:Dermatologic Agents; D004338:Drug Combinations; D006820:Hyaluronic Acid; D017364:Collagenases; D006851:Hydrochloric Acid