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Research Article| Volume 63, ISSUE 4, e358-e363, April 2010

The Nitric acid burn trauma of the skin

Published:October 30, 2009DOI:https://doi.org/10.1016/j.bjps.2009.09.001
The Nitric acid burn trauma of the skin
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      Summary

      Nitric acid burn traumata often occur in the chemical industry. A few publications addressing this topic can be found in the medical database, and there are no reports about these traumata in children.
      A total of 24 patients, average 16.6 years of age, suffering from nitric acid traumata were treated. Wound with I° burns received open therapy with panthenol-containing creams. Wound of II° and higher were initially treated by irrigation with sterile isotonic saline solution and then by covering with silver-sulphadiazine dressing. Treatment was changed on the second day to fluid-absorbent foam bandages for superficial wounds (up to IIa° depth) and occlusive, antiseptic moist bandages in combination with enzymatic substances for IIb°–III° burns. After the delayed demarcation, necrectomy and mesh-graft transplantation were performed. All wounds healed adequately.
      Chemical burn traumata with nitric acid lead to specific yellow- to brown-stained wounds with slower accumulation of eschar and slower demarcation compared with thermal burns. Remaining wound eschar induced no systemic inflammation reaction. After demarcation, skin transplantation can be performed on the wounds, as is commonly done.
      The distinguishing feature of nitric-acid-induced chemical burns is the difficulty in differentiation and classification of burn depth. An immediate lavage should be followed by silver sulphadiazine treatment. Thereafter, fluid-absorbent foam bandages or occlusive, antiseptic moist bandages should be used according to the burn depth. Slow demarcation caused a delay in performing surgical treatments.

      Keywords

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      Article info

      Publication history

      Published online: October 30, 2009
      Accepted: September 2, 2009
      Received in revised form: July 20, 2009
      Received: June 24, 2009

      Footnotes

      ☆The work was presented in part as an oral presentation at the DAV congress (German Association of Burn Injuries) in Leogang, Austria, in January 2009.

      Identification

      DOI: https://doi.org/10.1016/j.bjps.2009.09.001

      Copyright

      © 2009 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.

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