Background: To analyze the advanced planning of effective management and prevention for chemical burns, especially with the more severe cases.
Methods: A 10-year retrospective review was conducted for all patients with chemical burns admitted to the Department of Plastic Surgery in Taipei Veteran General Hospital from January 2011 to December 2020. The data obtained included age, gender, educational background, etiological agent, wound site, wound size and depth, inhalation injury or other accompanying injuries, first aids, length of hospital stay, morbidity and mortality.
Results: A total 22 patients were admitted to our department for in-hospital treatment of chemical burn over the 10-year period. There were 15 cases of males (68.18%) and 7 cases of female (31.82%) in total. The mean age was 45.18±19.18 years with a range of 17-83 years, which occurred most frequently in patients aged 30-39 years (22.72%). Most injuries took place at work-related sites (50%), most due to inappropriate handling of chemical substances (68.18%) or machine problems (27.27%). The predominant chemicals were acid (45.45%), with hydrofluoric acid (18.18%) as the leading one. Most patients received irrigation immediately (68.18%) after exposure to chemicals, but most was insufficient and for less than 30 minutes (59.09%). The extremities were the most common sites of injuries, with lower limbs (63.64%) slightly more than upper limbs (59.09%), followed by head and neck (27.27%). The mean total burn surface area (TBSA) was 12±0.24%, and there were 18 cases for TBSA <10% (81.82%). Most patients suffered from 3rd degree burn in the deepest injuries (50%). In all patients, 3 cases had inhalation injury (13.64%), while no ocular burn nor digestive tract injury was found. Surgical intervention was performed in 12 cases (54.55%), with 7 cases in total receiving skin graft (31.82%) or flap (4.55%) reconstruction. The average length of hospital stay was 18.32±28.17 days, ranging from 1 to 127 days. One case died from cardiac arrhythmia, and the other one died from sepsis and multiple organ failure, giving the overall mortality rate of 9.09%.
Conclusion: Due to the implementation of policy regarding to the public health, with the safety regulations for various industrial environments, chemical burns in Taiwan decreased in amount and in severity year by year. Although work-related chemical burn injuries were still the major reasons in our limited data, personal mistake was the leading point. The proper utilization of chemical substances as well as appropriate first aid after burn injuries with copious lavage for a sufficient period should be emphasized and well-educated.