Dr Rory Middleton1, Dr Thomas Whitton1, Dr Jennifer Martins1
1Royal Hobart Hospital, Hobart, Australia
Background: Although accounting for only a small percentage of total admissions to hospital for burns, chemical burns require special consideration due to their potential for delayed presentation, progression of tissue destruction and these burns frequently require surgical intervention. There has been an ongoing need for increased awareness and education about the risks of chemical burns and their management which have previously been outlined in many Burns centres, including the Tasmanian Burns Unit.
Method: We performed a search for patients of all ages admitted to the Tasmanian Burns Unit between 2008-2019 for chemical burns. 42 patients were identified and their cases reviewed. The results of this review were then compared with the findings of Ricketts and Kimble (2003).
Results: In comparison to the data collected by Ricketts and Kimble (2003), the majority of patients continue to be men between the ages 20-49 years, however the mean age has increased by 6 years to 38 years of age. There is a slight change observed in the location that the injury occurred, with 50% occurring in a domestic, and 38% occurring in an industrial setting. The most common causative agents were cement (33%) and Sodium hydroxide (31%). There was a 56% decrease in cases involving either sulphuric acid or hydrofluoric acid when compared to the previous study. The upper and lower limbs were involved in 79% of cases, with the face being involved in 24% of cases. The mean total surface area affected was 2.2% (compared with the previous 3.4%) and the mean length of stay was 5.5 days, a decrease from 9 between the years 1989-1999. Management of injuries continued to consist of various surgical and conservative management options which include debridement and split-thickness skin grafting as well as various dressings.
Conclusion: In comparison with the findings of Ricketts and Kimble (2003), there appears to be ongoing potential in both community and professional education for the prevention and management of chemical burns, with an emphasis on early management.
References: 1) Ricketts S and Kimble F, 2003. ‘Chemical injuries: the Tasmanian burns unit experience’. ANZ J Surg 73 (1-2): 45-48
Rory Middleton is a RMO at the Royal Hobart Hospital, interested in pursuing a career in Plastic Surgery.