[Management of dermatologic industrial accidents. Skin burns by bitumen as an example]

Comparison Between Two Strategies of Topical Treatment in Tar Burn: A Case Report

The management of tar burns presents a wide range of possible approaches, and several strategies can be used to reduce the damage regarding the removal of tar adhered to the patient's skin. Tar residues should preferably be emulsified with solvent solutions. Due to the low incidence of tar burns, it has not yet been possible to select the appropriate agent for the removal of the adhered tar. In this article, we reported a case of a 47-year-old man with a tar burn in his forehead region and his both upper limbs treated with two different approaches and the outcomes. In the right upper limb, the removal of tar with oil-based on essential fatty acids was attempted at the time of hospital admission, whereas in the left upper limb, he was treated with 1% silver sulfadiazine cream, sterile gauze, and bandage. On the right upper limb, the treatment was eventually performed with debridement and split-thickness skin grafting. On the left upper limb, there was complete re-epithelialization of the burns. The more conservative approach of keeping a dressing with 1% silver sulfadiazine on the tar itself, followed by removing the material in the dressing changes was considered better than the immediate removal of tar with an oily solution, especially about pain. Our impression was that the application of 1% silver sulfadiazine cream at the time of the admission, as well as in the following days, may be beneficial for the removal of the tar in close contact with the skin. Possibly, this approach leads to less trauma to the skin and, eventually, simplifies the treatment of burns by hot tar.