Pathology of chemical burns

2021-01-30 12:00 AM

In the army and during the war there are burns from rocket liquid fuel and military chemicals that cause blistering sores

Damage caused by chemicals on the skin and mucous membranes depends on:

Chemical and physical properties of chemicals.

Chemical concentration.

Duration of action.

Body area features.

How and when to be cured in the first period.

In peacetime, the rate of chemical burns accounts for about 5-6% of all burns. In the army and during the war there are also burns from rocket liquid fuels and military chemicals that cause cold sores. Some chemicals, when they act on the skin and mucous membranes, are still absorbed into the bloodstream into the body and can lead to death.

Chemicals that cause burn injuries include:

A solution of strong acids.

Salt some heavy metals.

A solution of strong bases.

Acid burns

Burns are common due to two main groups: metallic acids and organic acids.

Mechanism of burns

When the acid comes into contact with the skin, it will precipitate the proteins of the tissue and absorb the water of the cells, merging with the protein into the acid protein. The more concentrated the acid concentration and the prolonged exposure time, the faster and stronger the precipitation phenomenon, the deeper the burn.

Clinical characteristics

Burning, hot when being. The pain appears late. If it is a dilute acid solution, the pain lasts a few days.

Burn lesions usually appear as stains in different colours depending on the type of acid.

The burn of sulfuric acid is grey and then brown.

HNO3 burns at first yellow and then turn dark.

HCL burns are yellow-brown.

Burns of Trichloroacetic acid: white.

Burns of hydrofluoric acid: red with central necrosis.

Phrenic acid burns: dark green or red-yellow.

The acid burn lesion looks like a runny drop or a drop in ink or a dry clump of necrosis. The burn was not at first surrounded by red inflammation, but from day 12 onwards, surrounding edematous inflammation appeared.

Superficial acid burns: 4-10 days the necrotic layer of the epidermis will peel off, exposing a young epithelial background or granulation tissue with epithelial islands. Young skin or burn scarring is pink or darker than healed skin. Burns of the dermis are usually easy to heal from keloids.

Deep acid burns: When the burn is sunken in comparison to the surrounding healthy skin. Burns lose feeling complete, oedema is strong and long-lasting.

Burn necrosis from day 18-30 onwards. Particle tissue formed.

Some acids are toxic to the body such as formic acid, chromic acid, muriatic acid, sulfuric acid.

Treatment 

Must be administered immediately after a burn:

If acid gets on clothing and shoes, quickly remove the clothing from the shoes.

Use a lot of cold water to pour on the burned area or soak the burn area in water to dilute the acid concentration for more than 10 to 15 minutes and if burned due to hydro FL hydric acid, soaking in cold water must be longer, then use the medicine. to neutralize.

Acid neutralization with 10-20% sodium bicarbonate solution, soapy water, 2% lime water can be used with writing powder, toothbrush, magnesium hydroxide powder or rubbed on the burn lesions.

For some acids: after using the alkaline solution:

Hydro FL hydric Acid: Apply magnesium sulphate powder to the burn and inject calcium gluconate into the burn and inject calcium gluconate under the burn.

Carbolic acid: use herbal oils, glycerin, alcohol.

Phrenic acid, phenol: cover with herbal oil.

If the patient has to drink acid, rinse the mouth with 5% Sodium carbonate then drink egg white water, the amount depends on the amount of acid to drink. Do not take 5% Sodium carbonate that can cause acute gastric dilating gas or may cause perforation of the stomach and gastrointestinal tract.

It is also not advisable to put the catheter in the stomach for washing as this can cause perforation of the stomach.

Base burns

Mechanism of burns

Disintegrates tissue proteins and combines with the liquid proteins into alkaline proteinates.

Creates a saponification process with the lipids of a body cell.     
Quick lime (CaO) when meeting with water (H2O) forms hydrated lime Ca (OH) 2 in a thermal reaction (temperature up to 150oC) and slaked lime is a strong base (pH: 13.1).

Ammonium hydroxide (NH4OH: When breathing a lot of ammonia gas (NH3), the syndrome of laryngeal oedema and leading to acute pulmonary oedema.

Clinical characteristics

Common lesions

Bulging on the background of congested skin, oedema.

Gray wet necrosis.

Shallow and deep burns alternately.

Prolonged pain, complications of infection, purulent inflammation is common with blue pus infection.

Systemic symptoms

Immediately after burning, wash or soak in clean water to dilute base concentrations.

After washing, use acid solutions such as 6% acetic acid, 5% ammonium chloride (NH4Cl) solution, boric acid. If the above solution is not available, use 20% vinegar, lemon juice, or sugar water.

Burns caused by slaked lime: after using 3% boric acid solution to wash, use 10% ammonium chloride solution to wash off the remaining lime marks. Then tape with 3% boric acid.

Systemic treatment. Need shock prophylaxis, diuretic, high-dose antibiotics, humoral blood transfusion.

Several other types of burns

Hot bitumen burns: Use a mixture of herbal oil (3 parts) and kerosene (1 part) to clean off hot liquid tar that has stuck to your skin. Wipe the face, neck, chest area so that the burned person can easily breathe, then wipe other areas.