Hidroflorik aside bağlı kimyasal yanık hasarı: heksaflorin kullanılmadan başarı ile tedavi edilen bir olgu
Chemical burn injury due to hydrofluoric acid: a case of successful management without hexafluorine
We report an employee working in glass manufacturing who suffered a burn, induced by hydrofluoric acid (HF) as a result of an explosion of an acid container. The patient was admitted to our burn center with second and third degree burn injuries over 5% of his body. The burn improved completely and dramatically without application of hexafluorine because he presented to our burn center expeditiously. The primary goal of all treatment modalities is to prevent deep tissue injury, decomposing fluoride ion chemically. In the treatment of such burns, the wound area should be washed with plenty of water, preferably with bottled water. In addition, the compounds of calcium and magnesium applied topically and hexafluorine have a role in the treatment, where available. Training programs, including first-aid teams, should be prepared for this in order to reduce
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- 1. Yoshimura CA, Mathieu L, Hall AH, Monteiro MG, de Almeida DM. Seventy per cent hydrofluoric acid burns: delayed decontamination with hexafluorine and treatment with calcium gluconate. J Burn Care Res 2011;32:149-54. doi: 10.1097/ BCR.0b013e31822240f7.
- 2. Hatzifotis M, Williams A, Muller M, Pegg S. Hydrofluoric acid burns. Burns 2004;30:156-9. doi: 10.1016/j.burns.2003.09.031.
- 3. Dünser MW, Ohlbauer M, Rieder J, et al. Critical care management of major hydrofluoric acid burns: a case report, review of the literature, and recommendations for therapy. Burns 2004;30:391-8. doi: 10.1016/j.burns.2004.01.005.
- 4. ANSI. ANSI/ISEA Z358.1-2009 American National Standard for Emergency Eyewash and Shower Equipment. International Safety Equipment Association, Arlington, Virginia, September 14, 2009.
- 5. Ozcan M, Allahbeickaraghi A, Dündar M. Possible hazardous effects of hydrofluoric acid and recommendations for treatment approach: a review. Clin Oral Investig 2012;16:15-23. doi: 10.1007/s00784- 011-0636-6.
- 6. Aguilera IM, Vaughan RS. Calcium and the anaesthesist. Anaesthesia 2000;55:779-90.
- 7. Yamashita M, Suzuki M, Hirai H, Kajigaya H. Iontophoretic delivery of calcium for experimental hydrofluoric acid burns. Crit Care Med 2001;29:1575-8.
- 8. Wu ML, Deng JF, Fan JS. Survival after hypocalcemia, hypomagnesemia, hypokalemia and cardiac arrest following mild hydrofluoric acid burn. Clin Toxicol (Phila) 2010;48:953-5. doi: 10.3109/15563650.2010.533676.
- 9. Summers A. Treating burns caused by hydrofluoric acid. Emerg Nurse 2011;19:12-5; quiz 17. doi: 10.7748/ en2011.06.19.3.12.c8553.
- 10. Barillo DJ, Cancio LC, Goodwin CW. Treatment of whitephosphorus and other chemical burn injuries at one burn center over a 51-year period. Burns 2004;30:448-52. doi: 10.1016/j.burns.2004.01.032.
- 11. Sheridan RI, Ryan CM, Duinby Jr WC, Blair J, Tompkins RG, Burke JF. Emergency management of major hydrofluoric acid exposures. Burns 1995;21:62-4.
- 12. Lee DC. Treatment of inhalation exposure to hydrofluoric acid with calcium gluconate. J Occup Med 1993;35:47.
- 13. Salzman M, O’Malley RN. Updates on the evaluation and management of caustic exposures. Emerg Med Clin North Am 2007;25:459-76. doi: 10.1016/j. emc.2007.02.007.
- 14. Schiettecatte D, Mullie G, Depoorter M. Treatment of hydrofluoric acid burns. Acta Chir Belg 2003;103:375-8.
- 15. Hall AH, Blomet J, Gross M, Nehles J. Hexafluorine for emergent decontamination of hydrofluoric acid eye/skin splashes. Semiconductor Safety Assoc J 2000;14:30-33.
- 16. Soderberg K, Kuusinen P, Mathieu L, Hall AH. An improved method for emergent decontamination of ocular and dermal hydrofluoric acid splashes. Vet Hum Toxicol 2004;46:216-8.
- 17. Burgher F, Mathieu L, Lati E, et al. Part 2. Comparison of emergency washing solutions in 70% hydrofluoric acid-burned human skin in an established ex vivo explants model. Cutan Ocul Toxicol 2011;30:108-15. doi: 10.3109/15569527.2010.534748.
- 18. Hultén P,Höjer J,Ludwigs U,Janson A. Hexafluorine vs. standard decontamination to reduce systemic toxicity after dermal exposure to hydrofluoric acid. J Toxicol Clin Toxicol 2004;42:355-61.