Acute chemical skin injuries in the United States: a review

Abstract

The objective was to perform a thorough review of published and other available data to elucidate the extent of chemical skin injuries in the US. Chemical skin injuries differ significantly from skin lesions produced by other injury mechanisms, so this review was restricted to the former. Retrieval of relevant published data was performed in PubMed and Google. Other data were retrieved from the American College of Surgeons National Trauma Databank, American Burn Association National Burn Repository, US Department of Labor Bureau of Labor Statistics, websites of all 50 US States Departments of Health, and the National Poison Data System of the American Association of Poison Control Centers. Two areas of significance in disfiguring skin burn injuries and particularly of chemical skin injuries, psychosocial issues and the associated financial burden, have been briefly reviewed. Because of the paucity of published data, international as well as US data have been included. A brief description of an active flushing fluid as an alternative to potable water, Diphoterine solution, has also been included. Chemical skin injuries generally comprise approximately 2-5% of all skin burns, but sometimes higher percentages have been reported. Data analysis shows that while there are various sources regarding the epidemiology of chemical skin injuries, the total annual number cannot be determined because there is no centralized US national reporting mechanism. Literature and clinical experience demonstrate the importance of chemical skin injuries in USA. Dermal exposures to chemicals can result in mortality and morbidity. Chemical skin injuries can be avoided or ameliorated and preventive advanced measures should be taken to reduce or ameliorate them.

Presentations of tetramethylammonium hydroxide dermal exposure and the valuable potential of diphoterine solution in decontamination: a retrospective observational study

“…Upon a chemical splash, the severity of the injury and prognosis of the chemical damage on our body is determined by the following factors: 1. the toxic characters and concentration of the chemical; 2. the body surface size of the contacted area; 3. the duration of the chemical exposure; 4. the temperature of the chemical and environment; 5. if an appropriate decontamination has been exercised timely; 6. If needed, a proper medical treatment has been provided appropriately [11][12][13]. Lately, in industrial setting, upon chemical splash, immediate on site decontamination with appropriate rinsing solution to minimize the degree of the chemical burn and prevent further systemic toxicity has been considered as the principal purpose for emergent management [14].…”

“…Lately, in industrial setting, upon chemical splash, immediate on site decontamination with appropriate rinsing solution to minimize the degree of the chemical burn and prevent further systemic toxicity has been considered as the principal purpose for emergent management [14]. To be able to achieve this purpose, at least, a rinsing solution to be used is supposedly need to hold the following capacities: 1. to be able to neutralize the pH (acid or alkali); 2. to be able to consolidate (or inactivate) the active compound; 3. to be able to wipe off the chemical left on the body surface [11][12][13].…”

Blood Flow Dynamics in Burns

“…Chemical burns often behave quite like scalds, but there is a wide range on the exact behavior related to which chemical compound caused the burn [12]. Many chemical burns are also caused by a heated agent which will often have similar convective properties to water.…”

“…Many chemical burns are also caused by a heated agent which will often have similar convective properties to water. Chemical burns are most frequently caused by alkalis but in some geographic areas, acids are the leading cause [12,13]. Previously chemical burns were primarily caused by accidents in the industry, but domestic accidents are becoming more common [13].…”

“…Previously chemical burns were primarily caused by accidents in the industry, but domestic accidents are becoming more common [13]. Depending on the causing agent, different washing regimes can be used to rinse out the chemical compound that has already permeated the skin [12,13].…”