Assault by burning using corrosive substances – a 15-year experience in a Western regional burns unit and the real urgency for tighter legislations

D Barnes1, A Tan2, M Nizamoglu3, A Bharj4, P Dziewulski5

1St Andrew Center for Plastic and Burn Surgery, Court Road, CM1 7TH, UK. David.barnes@meht.nhs.uk
2St Andrew Center for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, alethea.tan@doctors.org.uk
3St Andrew Center for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, mnizam@doctors.org.uk
4BLAVA & CO. Solicitor, Uxbridge, London, amrit_bharj@hotmail.com
5St Andrew Center for Plastic and Burn Surgery, Court Road, CM1 7TH, UK, Peter.Dziewulski@meht.nhs.uk

Introduction

In the United Kingdom, burn injuries from corrosive substances are often industrial related work accidents. The incidence of acid assaults has gained awareness through several high profile cases. Victims of such assaults are often reluctant to pursue full criminal charges. The aim of this study was to review the circumstances of the assaults, patient outcomes, and current criminal proceedings. We also examined potential preventative strategies unique to this injury type.

Methodology

A 15 year retrospective analysis of all assault related burn injuries from corrosive substances was conducted using case notes review. Data was collected on patient demographics, burn demographics, management, patient outcomes and number of successful criminal charges.

Results

21 patients were identified. Male patients were almost three times more likely to be victims. Assaults were noted to more likely to occur in the age group of 25 years and below. Median TBSA% was 2, range of 0 to 16. Head and neck region was most common location of injury. 5/21 cases required surgical management with remaining   cases being managed conservatively. 4 cases required late reconstructive procedures. 9 cases had   involvement of the eye. Acid was used more frequently than alkali. 16/21attacks occurred on the street. Perpetrators were often known to the victims. The number of cases proceeding to criminal charges often diminishes for various reasons.

Conclusion

The management of assault related chemical burns requires a holistic approach. Enforcing legislation restricting access to corrosive substances and increasing severity of punishment may help reduce the incidence of these assaults.

Key Words

Acid assault; legislation; prevention

Biography

I am a consultant burn and reconstructive plastic surgeon at St Andrew Centre for Plastics and Burns, Chelmsford. Previously, I trained in North East England and did a specialist burn fellowship at Middlemore Hospital at Auckland which I thoroughly enjoyed. I have completed a  MSc in  Health Science and a degree in Biomedical Engineering. I play an active role in research and innovation in burns. Currently, I also hold the role of an educational tutor for the hospital and I am the current deputy of London South East Burn Network

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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