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Eftekhari H, Sadeghi M, Mobayen M, Esmailzadeh M, Feizkhah A, Lahiji MS, Taghizadeh Pourgarfami A, Toolaroud PB. Epidemiology of chemical burns: An 11-year retrospective study of 126 patients at a referral burn centre in the north of Iran. Int Wound J 2023; 20:2788-2794. [PMID: 36931904 PMCID: PMC10410324 DOI: 10.1111/iwj.14155] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 02/26/2023] [Accepted: 02/28/2023] [Indexed: 03/19/2023] Open
Abstract
The etiology and outcomes of chemical burns vary worldwide, influenced by the local population structure, industry distribution, and geographical and social environments. The aim of this study was to evaluate the epidemiology of chemical burns among patients referred to a burn centre in the north of Iran. A single-centre, retrospective study was conducted on patients with chemical burns between 2011 and 2021. Data collection was carried out using the hospital information system (HIS), and data collected from medical records included gender, age, marital status, occupations, burn season, place of residence, intention to burn, location of the accident, percent of total body surface area (%TBSA), the primary cause of burns, the body region of the burn, length of hospital stay (days), infection, and discharge status. The data were analysed using descriptive statistical methods and SPSS 24.0 software. Of the 10 133 burn patients treated in a burn centre in the north of Iran between 2011 and 2021, 1.2% had chemical burns. The average age of patients was 34.45 (SD = 22.16) years, and most chemical burns cases were male (70.6%, n = 89). Chemical burns occurred most frequently in patients aged 20 to 49 years (69.8%, n = 107), and most of the burns were accidental (84.9%, n = 107). The home was the most common place of chemical burn injury, accounting for 49.2% (62 cases), followed by the workplace (43.7%, n = 55), respectively. Most chemical burns occurred in the summer season (36.5%, n = 46), and acid (74.6%, n = 94) was the most common cause of chemical burns. The mean TBSA was 16.41 (SD = 15.10). The most common burn area was the lower limb (34.9%, n = 44), and the overall mortality rate was 4.8%. The average length of stay in the hospital was 6.53 (SD = 5.57) days. Community education on household safety, restricting non-specialists' access to chemical substances, and the promotion of early consultation could reduce chemical burn prevalence and improve outcomes.
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Affiliation(s)
- Hojat Eftekhari
- Skin Research Center, Department of Dermatology, Razi Hospital, School of MedicineGuilan University of Medical SciencesRahtGuilanIran
| | - Mahsa Sadeghi
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Mojdeh Esmailzadeh
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical Physics, School of MedicineGuilan University of Medical SciencesRashtIran
| | | | | | - Parissa Bagheri Toolaroud
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Health Information Management Research CenterKashan University of Medical SciencesKashanIran
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Kate A, Sharma S, Yathish S, Das AV, Malepati N, Donthineni PR, Basu S, D’Souza S, Shanbhag SS. Demographic profile and clinical characteristics of patients presenting with acute ocular burns. Indian J Ophthalmol 2023; 71:2694-2703. [PMID: 37417107 PMCID: PMC10491055 DOI: 10.4103/ijo.ijo_3330_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/23/2023] [Accepted: 05/30/2023] [Indexed: 07/08/2023] Open
Abstract
Purpose To study and compare the demographic and clinical profile of acute ocular burns (AOB) in children and adults. Methods This retrospective case series included 271 children (338 eyes) and 1300 adults (1809 eyes) who presented to two tertiary eye care centers within one month of sustaining AOB. Data regarding demographics, causative agents, severity of injury, visual acuity (VA), and treatment were collected and analyzed. Results Males were more commonly affected particularly among adults (81% versus 64%, P < 0.00001). Among children, 79% sustained domestic injuries, whereas 59% of adults had work-place injuries (P < 0.0001). Most cases were due to alkali (38%) and acids (22%). Edible lime (chuna, 32%), superglue (14%), and firecrackers (12%) in children, and chuna (7%), insecticides, lye, superglue (6% each), toilet cleaner (4%) and battery acid (3%) in adults, were the main causative agents. The percentage of cases with Dua grade IV-VI was greater in children (16% versus 9%; P = 0.0001). Amniotic membrane grafting and/or tarsorrhaphy were needed in 36% and 14% of affected eyes in children and adults, respectively (P < 0.00001). The median presenting VA was logMAR 0.5 in children and logMAR 0.3 in adults (P = 0.0001), which improved significantly with treatment in both groups (P < 0.0001), but the final VA in eyes with Dua grade IV-VI burns was poorer in children (logMAR 1.3 versus logMAR 0.8, P = 0.04). Conclusion The findings clearly delineate the at-risk groups, causative agents, clinical severity, and treatment outcomes of AOB. Increased awareness and data-driven targeted preventive strategies are needed to reduce the avoidable ocular morbidity in AOB.
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Affiliation(s)
- Anahita Kate
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Vijayawada, Andhra Pradesh, India
| | - Supriya Sharma
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Cornea and Anterior Segment Services, Shantilal Shanghvi Eye Institute, Mumbai, Maharashtra, India
| | - S Yathish
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Anthony Vipin Das
- Department of Eye Smart EMR and AEye, Indian Health Outcomes, Public Health and Economics Research Center, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Nikhila Malepati
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Pragnya R Donthineni
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sayan Basu
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Center for Ocular Regeneration (CORE), L V Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Hyderabad, Telangana, India
| | - Sharon D’Souza
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India
| | - Swapna S Shanbhag
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India
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Salvador-Culla B, Hogg J, Okonkwo A, Mulroy J, Figueiredo GS, Figueiredo FC. Severe chemical eye injuries - clinical outcomes and associated socio-economic factors. Scars Burn Heal 2023; 9:20595131231180367. [PMID: 37781443 PMCID: PMC10536839 DOI: 10.1177/20595131231180367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/03/2023] Open
Abstract
Aims To describe clinical outcomes, management, and socio-economic impact of severe acute chemical eye injuries in a tertiary hospital. Methods 37 patients required emergency admission to the Royal Victoria Infirmary eye ward between April 2013 and September 2015. Demographics, best corrected distance visual acuity (BCDVA), causative agent, degree of limbal stem cell deficiency (LSCD), management and socio-economic data were evaluated. Results Mean age on admission was 34.5 years (SD 16.3; range 16-82); 30 males (81.1%); 22 bilateral (59.5%). Causative agent: alkali in 30 cases (81.1%); acid in three cases (8.1%); and unknown in four cases (10.8%). Fifteen cases (40.5%) were assaults, 12 (32.5%) work-related accidents, nine (24.3%) domestic accidents and one (2.7%) undetermined. Eleven patients (29.7%) were unemployed, 18 (48.6%) were labourers, three (8.1%) were students, three (8.1%) were retired and two (5.4%) were professionals. Mean admission time was five days (SD 3.2; range 1-12). Mean follow-up time was 170.5 days (range 1-946). Mean cost of admission was £2478 (range £274-5785). Five patients (13%; seven eyes) developed total or partial limbal stem cell deficiency, all being assaults. Conclusions Main causative agent in our study was alkali, with young men in the working age being most frequently involved. Many patients required prolonged hospital admission and costly follow-up. The majority of cases were assaults, mostly occurring in unemployed patients. All the limbal stem cell deficiency cases were due to assaults. We believe that socio-economic factors play an important role in the cause, severity and cost of chemical eye injuries. Lay Summary Acute chemical eye injuries have a significant and extensive impact on patients' visual function outcomes and vision-related quality of life, with consequent enormous burden to affected individuals, their families and society. We believe that by understanding the socio-economic environment, we may not only be able to enforce safety measures to tackle the increasing rate of severe chemical eye injuries in our community, but also to develop collaborative programmes with the community, educating the population on the seriousness of chemical eye injuries, and with the local authorities, trying to understand the clustering of assaults in areas and tackling the associated socio-economic risk factors, such as unemployment. Given the increasing rate of assaults using chemicals in recent times, it is also important to assess availability of adequate victim support programmes and develop good interaction with relevant local, regional and national authorities to ensure all aspects of community security service are in place to be able to address any potential deficiencies in line with police and home office guidelines. Keeping in mind that the best action plan is always prevention. However, when an ocular injury does occur it is evident that significant morbidity and visual sequelae can result and affect the socio-economic status of the victims despite our best current medical and surgical care.
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Affiliation(s)
| | - Jeffrey Hogg
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Arthur Okonkwo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | - Julie Mulroy
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
| | | | - Francisco C. Figueiredo
- Department of Ophthalmology, Royal Victoria Infirmary, Newcastle upon Tyne, UK
- Bioscience Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
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Kaplan AT, Yalcin SO, Günaydın NT, Kaymak NZ, Gün RD. Ocular-periocular burns in a tertiary hospital: Epidemiologic characteristics. J Plast Reconstr Aesthet Surg 2023; 76:208-215. [PMID: 36527902 DOI: 10.1016/j.bjps.2022.10.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 10/10/2022] [Accepted: 10/25/2022] [Indexed: 11/08/2022]
Abstract
PURPOSE Ocular burns are ophthalmic emergencies that can cause devastating injuries. This study aimed to analyze the epidemiology, complications, and management of ocular-periocular burns. METHODS A total of 193 patients with ocular-periocular burns were admitted to our tertiary hospital from January 2018 to December 2020. The demographic characteristics of the patients, injury variables, complications, and treatments were evaluated. RESULTS There were 142 male (73.6%) and 51 female (26.4%) patients with a mean age of 32.53±17.75 years. The average total body surface area was 12% (range, 1-80%). Injuries were most common at work (52.3%) and home (36.3%). Thermal burns were the most common injuries (74.6%), followed by chemical (14.5%) and electrical burns (10.9%). Alkaline agents (75.0%), mainly sodium hydroxide and lime, were common in chemical burns. Superficial lid burns were significantly higher in the thermal group (p < 0.001), and grade III-IV corneal burns were significantly higher in the chemical group (p < 0.001). Various complications were developed in 50 (13%) eyes. Medical treatment only was performed in 318 (82.4%) eyes, and additional surgical treatment was performed in 64 (17.6%) eyes; however, 54 (14.0%) underwent more than one surgery. The most common complications were corneal scars (7.3%), limbal deficiency (4.1%), and ectropion (3.9%). The most frequent procedures performed were amniotic membrane transplantation (AMT) (11.9%) and tarsorrhaphy (6.7%). CONCLUSION Chemical burns, limbal and conjunctival ischemia, and full-thickness eyelid defects had a poor prognosis. The degree of limbal deficiency and ınjury of intraocular structures were found to have a great influence on the outcome of their visual acuity.
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Affiliation(s)
- Aysin Tuba Kaplan
- Ophthalmology Department, SBU Kartal Dr. Lutfi Kırdar City Hospital, Kartal, Istanbul 34865, Turkey.
| | - Sibel Oskan Yalcin
- Ophthalmology Department, SBU Kartal Dr. Lutfi Kırdar City Hospital, Kartal, Istanbul 34865, Turkey
| | - Nesrin Tutas Günaydın
- Ophthalmology Department, SBU Kartal Dr. Lutfi Kırdar City Hospital, Kartal, Istanbul 34865, Turkey
| | - Nilüfer Zorlutuna Kaymak
- Ophthalmology Department, SBU Kartal Dr. Lutfi Kırdar City Hospital, Kartal, Istanbul 34865, Turkey
| | - Raziye Dönmez Gün
- Ophthalmology Department, SBU Kartal Dr. Lutfi Kırdar City Hospital, Kartal, Istanbul 34865, Turkey
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Al-Ghadeer H, Al Amry M, Aldihan KA, Alobaidan OS, AlQahtani GMS, Khandekar R. Demographic, Clinical Profile and Management Outcomes of Ocular Chemical Injuries in Saudi Children. Clin Ophthalmol 2022; 16:3247-3255. [PMID: 36211717 PMCID: PMC9534152 DOI: 10.2147/opth.s379081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 09/09/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Huda Al-Ghadeer
- Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
- Correspondence: Huda Al-Ghadeer, Emergency Department, King Khaled Eye Specialist Hospital, PO Box 7191, Riyadh, 11462, Saudi Arabia, Tel +966 1 4821234 ext. 2500, Email
| | - Mohammed Al Amry
- Emergency Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Khalid A Aldihan
- Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | - Omar S Alobaidan
- Ophthalmology Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
| | | | - Rajiv Khandekar
- Research Department, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Sen P, Tripathi P, Mohan A, Agarwal K, Shah C, Parmar G, Sen A. Chemical injury with “packet of chunna” (lime) in children: A major ocular health concern in central rural India. JOURNAL OF CLINICAL OPHTHALMOLOGY AND RESEARCH 2022. [DOI: 10.4103/jcor.jcor_54_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Arora R, Saran R, Jha V, Gotmare ND, Jain P. Immunocytochemistry of the ocular surface after different techniques of limbal stem cell transplantation for chronic chemical burns. Br J Ophthalmol 2020; 106:461-466. [PMID: 33328186 DOI: 10.1136/bjophthalmol-2020-317051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/18/2020] [Accepted: 11/28/2020] [Indexed: 11/04/2022]
Abstract
AIM To compare the immunocytochemistry (ICC) on impression cytology of corneal surface epithelium after simple limbal epithelial transplantation (SLET) and conjunctival-limbal autograft (CLAU). METHODS A prospective study of 20 patients above 1 year of age with chronic chemical burns, who underwent limbal stem cell transplantation (LSCT). They were divided equally in group A (SLET) and group B (CLAU). ICC was done for cytokeratin 3 (CK3) and cytokeratin 19 (CK19), preoperatively and postoperatively at 6 months. RESULTS Four cases were excluded due to inadequate cellularity in preoperative or postoperative samples. On ICC analysis, in the remaining 16 patients mean CK3 and CK19 positivity changed from 2.06%±1.73% and 83.56%±8.69% preoperatively to 70.62%±13.2% (p<0.0001) and 5.93%±4.17% (p<0.0001), respectively, at 6 months post LSCT. In group A (8 patients) mean CK3 and CK19 positivity of 2%±1.8% and 84.5%±8.4% preoperatively changed to 70%±13.8% (p<0.0001) and 6.25%±5.1% (p<0.0001) at 6 months respectively. While in group B (8 patients), it was 2.12%±1.7% and 82.62%±9.4% preoperatively and 71.25%±013.5% (p<0.0001) and 5.62%±3.2% (p<0.0001) at 6 months. There was no significant difference in expression of CK3 (p=0.084) and CK19 (p=0.744) post SLET or CLAU.Three patients with complete reversion had clear corneas at 6 months. CONCLUSION Reversion of the epithelium to corneal phenotype was documented post LSCT with no difference in expression of CK3 between the two procedures (SLET/CLAU).
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Affiliation(s)
- Ritu Arora
- Ophthalmology, Guru Nanak Eye Centre, New Delhi, Delhi, India
| | | | - Vikas Jha
- Ophthalmology, Guru Nanak Eye Centre, New Delhi, Delhi, India
| | | | - Parul Jain
- Ophthalmology, Guru Nanak Eye Centre, New Delhi, Delhi, India
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Wang F, Cheng J, Zhai H, Dong Y, Li H, Xie L. Correlation analysis of the clinical features and prognosis of acute ocular burns-exploration of a new classification scheme. Graefes Arch Clin Exp Ophthalmol 2019; 258:147-155. [PMID: 31713750 DOI: 10.1007/s00417-019-04525-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/04/2019] [Accepted: 10/23/2019] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To explore a new classification scheme for acute ocular burns. METHODS Medical records of 345 patients (450 eyes) with acute ocular burns treated at Shandong Eye Institute between January 2013 and January 2018 with a 12-month minimum follow-up were retrospectively reviewed. A total of 8 parameters in the acute phase were evaluated and graded on a scale from 0 to 3 according to their severity. RESULTS The key factors affecting the prognosis of acute ocular burns were conjunctival involvement (386 eyes, 85.8%), corneal epithelial defect (349 eyes, 77.6%), and limbal ischemia (244 eyes, 54.2%). Visual acuity in 181/450 eyes (40.2%) was worse than 6/60. The injury severity of the cornea, limbus, bulbar conjunctiva, eyelid, and fornix and intraocular signs in the acute phase was significantly correlated with the logarithm of the minimum angle of resolution (logMAR) visual acuity (correlation coefficient [R] 0.481-0.933, P < 0.0001) and corneal opacification, neovascularization, and symblepharon scores in the stable phase (R 0.513-0.855, P < 0.0001). The mean total score for the 8 parameters in the acute phase was 5.34 ± 4.04 (range 0-14); higher scores indicated worse visual acuity (R = 0.899, P < 0.0001). The total score for acute-phase parameters was significantly correlated with that for the stable-phase parameters (R = 0.872, P < 0.0001). CONCLUSIONS The severity of acute-phase parameters is significantly correlated with the final visual outcome and prognosis. The new grading scheme can help clinicians more accurately analyze the degree of ocular burns, determine a reasonable treatment protocol, and rationally evaluate the prognosis.
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Affiliation(s)
- Fuyan Wang
- Department of Ophthalmology, Clinical Medical College of Shandong University, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Jun Cheng
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Hualei Zhai
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Yanling Dong
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Hua Li
- Department of Ophthalmology, Clinical Medical College of Shandong University, Jinan, China.,State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China
| | - Lixin Xie
- State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Institute, Shandong First Medical University & Shandong Academy of Medical Sciences, Qingdao, China.
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Majeed S, Rahman MU, Majeed H, Rahman SU, Hayat A, Smith SD. Chemical mismanagement and skin burns among hospitalized and outpatient department patients. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:817-830. [PMID: 31251122 DOI: 10.1080/10803548.2019.1638142] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Purpose. This article attempts to elucidate the nature of chemicals causing major and minor skin burns, and their associated characterization across different industries, using Fujian provincial hospitals' admission and outpatient department records. Materials and methods. Data were collected from the provincial hospitals of Fujian through a questionnaire, sent via email, from June 1, 2017 to November 30, 2017. The collected responses were statistically analyzed using SPSS version 19 through the interquartile range, median, Mann-Whitney U test and Fisher's exact test with two-tailed significance. Results and conclusions. The results of 306 collected responses reveal that the majority of skin burn cases are due to a lack of technical education and professional training among workers handling chemicals. This study suggests that management's effective supervision and governmental regulations may help to prevent chemical skin burns at work, and can further be controlled by hiring professional workers alongside providing training to them in chemical handling as well as using protective equipment and developing appropriate management policies to improve victims' well-being and quality of life. Findings will help workers, doctors, hospitals, industries, government and other stakeholders to understand and control chemical hazards on site to minimize the risks of chemical skin burn incidents.
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Affiliation(s)
| | | | - Hammad Majeed
- Department of Chemistry, University of Agriculture, Pakistan
| | - Sami Ur Rahman
- Urban Policy Unit Planning and Development Department, Government of Khyber Pakhtunkhwa (UPU, P&DD GoKP) Civil Secretariat, Pakistan
| | - Asif Hayat
- College of Chemistry, Fuzhou University, China
| | - Sandra D Smith
- University of Auckland Business School, University of Auckland, New Zealand
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Bizrah M, Yusuf A, Ahmad S. An update on chemical eye burns. Eye (Lond) 2019; 33:1362-1377. [PMID: 31086244 PMCID: PMC7002428 DOI: 10.1038/s41433-019-0456-5] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/06/2019] [Accepted: 04/02/2019] [Indexed: 01/20/2023] Open
Abstract
Ocular chemical injuries vary in severity, with the more severe end of the spectrum having profound visual consequences and medicolegal implications. Grading of ocular injuries is critical for determining acute treatment and visual prognosis. Poor immediate management results in more challenging treatment of acute disease. Similarly, poorly controlled acute disease results in more treatment-resistant chronic ocular disease. Despite several decades of research and public health initiatives, simple and effective interventions such as wearing protective eyewear and immediate irrigation of eyes remain as key challenges. Education and prevention are therefore important public health messages. Hurdles in the acute management of disease include poor evidence-base for commonly used treatments (e.g. based on experimental animal studies), reduced treatment adherence rates and high clinic non-attendance rates. The evolution of treatment strategies, particularly limbal stem cell transplantation, has revolutionised the visual and cosmetic outcomes in chronic phases of disease. It is therefore increasingly important to consider tertiary referral for patients with limbal stem cell failure or vision-limiting corneal scarring.
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Affiliation(s)
- Mukhtar Bizrah
- Imperial College Healthcare NHS Trust, Western Eye Hospital, 153-173 Marylebone Road, London, NW1 5QH, UK.
| | - Ammar Yusuf
- UCL Institute of Ophthalmology, 11-43 Bath Street, London, EC1V 9EL, UK
| | - Sajjad Ahmad
- Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
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Adherence to Treatment and Follow-Up in Patients with Severe Chemical Eye Burns. Ophthalmol Ther 2019; 8:251-259. [PMID: 30868417 PMCID: PMC6514011 DOI: 10.1007/s40123-019-0173-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Indexed: 11/02/2022] Open
Abstract
INTRODUCTION To investigate the demographics, acute management and compliance rates of severe chemical eye burn cases that presented to the largest eye hospital in the United Kingdom (UK). METHODS All patients presenting to the Moorfields Eye Hospital emergency department are registered on the electronic patient administration system (PAS). A search of the PAS for patients assigned a preset diagnosis of 'chemical injury' was performed for the period from 1 January to 31 March 2016. The results of the PAS search and handwritten clerking notes were reviewed. Eyes that were found to have ≥ 33% limbal ischaemia or limbal staining, or corneal haze that obscured the details of the iris, were recorded as having severe chemical injuries. RESULTS 55 patients had mild chemical eye burns, and 11 eyes of 10 patients had severe burns. Average patient age was 37 years (SD 22 years) and 22 years (SD 10 years) for mild and severe chemical injuries, respectively. 53% of the mild injuries and 90% of the severe injuries were in males. 7 (70%) of the 10 severe injuries were assault-related. In the severe chemical injuries group, first presentation to the emergency department was 24 h or more postinjury in 50% of the patients, 33% stopped ascorbate and citrate drops (ocular pain), 40% stopped attending clinical follow-up sessions, and 45% of the eyes had a final best corrected visual acuity (BCVA) of 6/18 or worse. CONCLUSION A significant proportion of the severe ocular chemical burns were assault-related. Delayed presentation and poor treatment adherence and follow-up attendance rates are significant challenges in patients with severe chemical burns. Patient education and public health awareness are important strategies. These findings also raise the question of whether these patients, who are mostly young males, should be admitted to improve treatment adherence rates and visual outcome.
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Acute Chemical Eye Injury and Limbal Stem Cell Deficiency-A Prospective Study in the United Kingdom. Cornea 2019; 38:8-12. [PMID: 30199398 DOI: 10.1097/ico.0000000000001739] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To analyze the incidence, nature, outcomes, and complications of acute chemical eye injuries, including the incidence of limbal stem cell deficiency (LSCD) and to compare the 2 main classifications for ocular chemical injuries: Roper-Hall (RH) and Dua. METHODS This is a prospective, consecutive, interventional single-center study between April and October 2009 of all new patients with acute chemical eye injury presenting to the Royal Victoria Infirmary eye emergency department (EED). RESULTS Of 11,683 patients who attended the EED, 98 patients (110 eyes) presented with acute chemical eye injury (60% male). This represents an estimated annual incidence of 5.6 new cases per 100,000 population. Mean age was 36.5 years (1-78; SD 17.1 years), including 7 children (age <10 years). Fifty-one patients (52%) had work-related injuries. The most common chemical agent was alkali (78%). All 4 RH grade IV cases were unilateral, assault with ammonia, and required early amniotic membrane transplantation as per the protocol, but despite full treatment, they developed total LSCD in the affected eye. CONCLUSIONS Acute chemical eye injuries are rare. Male patients in the working age group are more prone to work-related chemical injuries, whereas young children tend to have domestic injuries. Grade I, II, and III RH and Dua chemical injuries had a very good prognosis with topical treatment only, whereas RH grade IV (Dua grade IV-VI), mainly assaults with ammonia, progressed to total/severe LSCD despite appropriate management including early amniotic membrane transplantation. The Dua classification includes conjunctival involvement, having a greater value in predicting the final clinical outcome when grading chemical eye injuries.
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Wang Y, Yu X, Qian W, Zhou D, Yang T, Wang S, He W, Luo G. Epidemiologic Investigation of Chemical Burns in Southwestern China from 2005 to 2016. J Burn Care Res 2018; 39:1006-1016. [PMID: 29939259 DOI: 10.1093/jbcr/iry032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The epidemiological characteristics of chemical burns vary in different regions of the world. This study aims to survey the epidemiology, outcomes, and costs of chemical burns in southwest China, to determine associated risk factors and to obtain data for developing an effective approach to prevent and treat chemical burns. This retrospective study includes 410 cases with chemical burns admitted to the Institute of Burn Research of Southwest Hospital from 2005 to 2016. Data, including demographic, etiology, outcomes, and costs, were collected and analyzed. A total of 410 cases admitted to our burn center were included. The average age of the burn patients was 38.58 ± 14.66 years. The incidence of chemical burns peaked in autumn. The most common etiology were acids. Limbs were the most common burn sites (59.51%). Average total body surface area (TBSA) was 12.37 ± 18.67%. The percentage of patients who underwent procedures and the number of procedures were significantly greater for TBSA and full-thickness burns. The mortality of chemical burns was 1.22%. The median length of stay (LOS) and cost were 21 days and 65,852 CNY, respectively. The major risk factors for cost were the number of procedures, TBSA and full-thickness burns, the major risk factors for LOS were the number of procedures and outcome. Chemical burns mainly occurred in adult males with occupational exposures to chemical agents due to inappropriate operation. Emphasis on safety education for the public and professional pre-employment training for workers should become key preventive targets to reduce the incidence of chemical burns.
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Affiliation(s)
- Yangping Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Xunzhou Yu
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Wei Qian
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Daijun Zhou
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Tao Yang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Song Wang
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Weifeng He
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
| | - Gaoxing Luo
- Institute of Burn Research, State Key Laboratory of Trauma, Burn and Combined Injury, Key Laboratory of Disease Proteomics of Chongqing, Southwest Hospital, Army Medical University, China
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Blindness as a result of acid attacks in Cambodia. ASIAN BIOMED 2018. [DOI: 10.2478/abm-2010-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Background: Fifty-three patients who had been attacked with acid were treated over the last three years, and 45% suffered blindness in one or both eyes as a result. Objective: Review the charts of all 53 patients to see if the proximate cause of the blindness could be determined to prevent it happening to others. Results: Three principal causes of blindness were direct damage from acid, limbal stem cell loss leading to later eyeball perforation, and delayed corneal abrasion from eyelid deformity. Only the latter cause could be prevented at this time, since the strength of the acid used in the attack could not be controlled, nor could limbal stem cell transplants be performed. Conclusion: Assessment of the ophthalmic injuries revealed three main categories of visual impairment, only one of which could be treated effectively at this stage.
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Ji KB, Ling L, Zhang Q, Chou JJ, Yang XL, Wang ZH, Yin L, Wu SF, Yu YF. MicroRNA-296 mediated corneal neovascularization in an animal model of corneal burns after alkali exposures. Exp Ther Med 2018; 15:139-144. [PMID: 29399058 PMCID: PMC5769237 DOI: 10.3892/etm.2017.5408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 10/30/2017] [Indexed: 12/31/2022] Open
Abstract
Alkali burns of the cornea may lead to permanent visual impairment or complete blindness. In the current study, the role of microRNA 296 (miR-296) was explored in mouse corneal neovascularization induced by alkali burns. An alkali burn model in Balb/c mice was developed to study chemical corneal injuries. The expression of the miR-296 gene was measured by reverse-transcription-quantitative polymerase chain reaction. Fibroblast growth factor 23 (FGF23) protein expression was measured by western blot analysis. Possible impacted pathways were analyzed by Kyoto Encyclopedia of Genes and Genomes pathway analysis. miR-296 gene expression was examined following chemical corneal injury and it was demonstrated that different topical eye medications decreased miR-296 gene expression. miR-296 may participate in cytokine-cytokine receptor interaction pathways to influence corneal inflammatory responses. It was also revealed that FGF23 was expressed following chemical corneal injury and that different treatments with topical eye drops decreased its expression. miR-296 is a novel molecular modulator for alkali burns in the mouse cornea.
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Affiliation(s)
- Kai-Bao Ji
- Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi 330006, P.R. China
| | - Ling Ling
- Department of Ophthalmology, Affiliated Eye Hospital of Nanchang University, Jiangxi Provincial Key Laboratory for Ophthalmology, Nanchang, Jiangxi 330006, P.R. China
| | - Qian Zhang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Jing-Jing Chou
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Xia-Ling Yang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Zhi-Hong Wang
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Li Yin
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Shu-Fang Wu
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
| | - Yi-Feng Yu
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, P.R. China
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Koh DH, Lee SG, Kim HC. Incidence and characteristics of chemical burns. Burns 2017; 43:654-664. [DOI: 10.1016/j.burns.2016.08.037] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 08/27/2016] [Accepted: 08/31/2016] [Indexed: 10/20/2022]
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Zhang Y, Zhang J, Jiang X, Ni L, Ye C, Han C, Sharma K, Wang X. Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study. J Occup Med Toxicol 2016; 11:55. [PMID: 27980604 PMCID: PMC5142164 DOI: 10.1186/s12995-016-0144-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Accepted: 12/02/2016] [Indexed: 11/23/2022] Open
Abstract
Background Chemical burns caused by hydrofluoric acid (HF) frequently occur in the Western Zhejiang Province. This study aimed to investigate the epidemiological characteristics of HF burns within this region. Methods A 10-year retrospective analysis was conducted using data from all inpatients with HF burns. These patients were treated at the Department of Burns and Plastic Surgery at our hospital between January 2004 and December 2013. Information obtained for each patient included sex, age, occupation, burn location, burn cause, and the hazard category of the chemical which caused the burn. Data regarding wound site and size, accompanying injuries, serum electrolyte levels, operations, length of hospital stay, and mortality were also assessed. Results A total of 201 patients (189 males, 12 females; average age: 38.33 ± 10.57 years) were admitted due to HF burns. Over the 10-year period, the morbidity of HF burns in the past 10 years showed a gradual increase, which paralleled the development of local fluoride industries. Most HF injuries were work related and distributed in working-age patients. Aqueous HF solutions, especially highly concentrated ones, were the most common chemical cause of HF burns. Moreover, inappropriate operation, machine problems, and inadequate protection were identified as the leading causes of HF burns in the workplace. The burn area was <5% of TBSA in more than 90% of patients, and the most common burn sites were the head, neck, and upper extremities. Approximately 17% of patients underwent surgical operation. Accompanying injuries should be detected and treated correctly in a timely manner. Lastly, electrolyte imbalances, such as hypocalcaemia, hypomagnesaemia, and hypokalaemia, occurred frequently in patients with HF exposure; however, hyperkalaemia was not encountered in this study. Conclusion Based on the epidemiological results for HF burns in this region, the related enterprises and local authorities should be encouraged to upgrade management policies and to provide necessary occupational hazard education and safety training for high-risk occupations within high-risk working populations. Furthermore, the enhancement of hazardous chemicals management is also needed. Finally, for patients with HF exposure, early and correct pre-hospital triage, treatment and consequent in-hospital treatment and procedures should also be improved.
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Affiliation(s)
- Yuanhai Zhang
- Department of Burns & Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, 324004 China
| | - Jianfen Zhang
- Department of Burns & Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, 324004 China
| | - Xinhua Jiang
- Department of Burns & Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, 324004 China
| | - Liangfang Ni
- Department of Burns & Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, 324004 China
| | - Chunjiang Ye
- Department of Burns & Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, 324004 China
| | - Chunmao Han
- Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, 310009 China
| | - Komal Sharma
- Zhejiang University School of Medicine, Hangzhou, 310000 China
| | - Xingang Wang
- Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University College of Medicine, Hangzhou, 310009 China
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Ye C, Wang X, Zhang Y, Ni L, Jiang R, Liu L, Han C. Ten-year epidemiology of chemical burns in western Zhejiang Province, China. Burns 2016; 42:668-74. [PMID: 26803372 DOI: 10.1016/j.burns.2015.12.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 11/22/2015] [Accepted: 12/05/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Chemical burns occur frequently in western Zhejiang Province. This study documents the epidemiology of chemical burns in the region using burn data from a local specialized hospital. Results from this analysis will assist in the planning of prevention strategies for high-risk occupations and groups. METHODS A 10-year retrospective analysis was conducted for all patients with chemical burns admitted to the Department of Burn and Plastic Surgery from January 2004 to December 2013. Information obtained for each patient included demographics (gender, age, occupation and education), location of the burn, cause of the burn, and categories of chemicals. Data regarding the season of admittance, prehospital treatment, wound site/size (area, region, and depth), accompanying injuries, operations, length of hospital stay and mortality were also assessed. RESULTS A total of 690 patients (619 males, 71 females; average age: 30.6±12.4 years) were admitted to the department for chemical burns. Over the 10-year period, the incidence of chemical burns showed an increasing tendency. Chemical burns occurred most frequently in patients aged 20-59 years (94.79%). Most of the chemical burns were work-related, primarily in private enterprises (47.97%) and state-owned enterprises (24.93%). Operations (68.99%) and machine problems (17.26%) were the main causes of chemical burns in the workplace. With regard to burns caused by chemicals, most were caused by acids (72.01%), with hydrofluoric acid and sulphuric acid causing 51.45%. Most chemical burns occurred in the summer and autumn seasons (61.02%). The burn size was <10% of the total body surface area (TBSA) for 445 patients (64.49%), while only 26 patients (3.76%) had burns covering >40% TBSA. The most common burn sites were the upper extremities (31.57%), lower extremities (19.86%), and head and neck (28.83%). Most patients (581 (84.20%)) received water washing treatment on site immediately after exposure. The most common accompanying injuries included inhalation injury, ocular burns and digestive tract injury. The average hospital stay was 17.0±23.1 days (range 1-333 days). Surgery was performed in 146 patients (21.16%), and the overall mortality rate was 0.58%. CONCLUSIONS Chemical burns are preventable. The high morbidity of chemical burns in western Zhejiang Province is related to the industrial structure of the area. Governmental management in the fields of production, transportation, and utilization of chemicals could be improved. Workplaces have the responsibility to provide safe work environments and equipment, as well as occupational education and safety training for high-risk work groups.
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Affiliation(s)
- Chunjiang Ye
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China
| | - Xingang Wang
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China.
| | - Yuanhai Zhang
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China
| | - Liangfang Ni
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China
| | - Ruiming Jiang
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China
| | - Liping Liu
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou, China
| | - Chunmao Han
- Department of Burns & Wound Care Center, 2nd Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, China
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Chemical Burn Injury in Kumasi: The Trend and Complications following and Their Management. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2015; 3:e548. [PMID: 26579354 PMCID: PMC4634185 DOI: 10.1097/gox.0000000000000519] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 08/28/2015] [Indexed: 01/08/2023]
Abstract
A chemical burn refers to irritation and destruction of human tissue caused by exposure to a chemical, usually by direct contact with the chemical or its fumes. The study investigated the trend and complications following chemical burns and their management.
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Chemical burns revisited: What is the most appropriate method of decontamination? Burns 2015; 41:761-3. [DOI: 10.1016/j.burns.2014.10.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 10/06/2014] [Accepted: 10/08/2014] [Indexed: 11/21/2022]
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Wang X, Zhang Y, Ni L, You C, Ye C, Jiang R, Liu L, Liu J, Han C. A review of treatment strategies for hydrofluoric acid burns: Current status and future prospects. Burns 2014; 40:1447-57. [DOI: 10.1016/j.burns.2014.04.009] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 03/21/2014] [Accepted: 04/19/2014] [Indexed: 11/15/2022]
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Yuanhai Z, Xingang W, Liangfang N, Chunmao H. Management of a Patient With Faciocervical Burns and Inhalational Injury Due to Hydrofluoric Acid Exposure. INT J LOW EXTR WOUND 2014; 13:155-159. [PMID: 24807997 DOI: 10.1177/1534734614534441] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hydrofluoric acid, a highly dangerous substance, can cause tissue damage and systemic toxicity by its unique mechanisms. Many cases of severe faciocervical burns due to hydrofluoric acid exposure are lethal. Herein, we present a case of 37-year-old man who suffered from hydrofluoric acid burns to his face, anterior neck, lips, and nasal cavity. On admission, this patient coughed with much sputum, and the chest auscultation detected rough breath sounds, wheezes, and very weak heart sounds, indicating possible inhalation injury. This case highlights the extreme complexity of managing this kind of injury. Timely and accurate wound treatment and respiratory tract care, as well as active systematic support treatment, played vital roles in the management of this patient.
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Affiliation(s)
| | - Wang Xingang
- 2nd Affiliated Hospital of Zhejiang University, Hangzhou, China
| | | | - Han Chunmao
- 2nd Affiliated Hospital of Zhejiang University, Hangzhou, China
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Hardwicke J, Bechar J, Bella H, Moiemen N. Cutaneous chemical burns in children – A comparative study. Burns 2013; 39:1626-30. [DOI: 10.1016/j.burns.2013.04.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 04/10/2013] [Accepted: 04/11/2013] [Indexed: 11/25/2022]
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Ten-year epidemiological study of chemical burns in Jinshan, Shanghai, PR China. Burns 2013; 39:1468-73. [DOI: 10.1016/j.burns.2013.03.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 03/18/2013] [Accepted: 03/21/2013] [Indexed: 11/18/2022]
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Vajpayee RB, Shekhar H, Sharma N, Jhanji V. Demographic and clinical profile of ocular chemical injuries in the pediatric age group. Ophthalmology 2013; 121:377-380. [PMID: 23948464 DOI: 10.1016/j.ophtha.2013.06.044] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 06/22/2013] [Accepted: 06/25/2013] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE To review the risk factors, management, and visual outcomes of pediatric chemical eye injuries in a tertiary care hospital in North India. DESIGN Retrospective hospital-based study. PARTICIPANTS Patients aged <16 years with ocular chemical burns. METHODS Case records of patients with ocular chemical injury who presented to the Dr. Rajendra Prasad Centre for Ophthalmic Sciences were reviewed over a 5-year period. MAIN OUTCOME MEASURES Demographic profile, nature of chemical injury, complications, and visual outcomes after chemical injury. RESULTS A total of 134 pediatric patients with a history of ocular chemical burns were seen between March 2006 and March 2011. The mean age of patients at the time of injury was 8.95±4.89 years (range, 1.2-15.5 years); 63.4% were male. Sixty-nine patients (51.4%) belonged to the preschool (0-5 years) age group. Bilateral chemical injuries were seen in 24 patients (17.9%). Lime ("chuna") was the most commonly involved chemical (88, 65.6%) followed by toilet cleaner (20, 14.9%). The mean time between injury and presentation was 68.3 days (range, 1-365 days). Severe (grade 3 and 4) ocular chemical injury was seen in 94 patients (70.1%). Surgical intervention was performed in 114 eyes (85%) in the form of amniotic membrane grafting (n = 78), symblepharon release (n = 56), limbal stem cell transplantation (n = 26), and lamellar keratoplasty (n = 14). The average number of surgeries conducted per patient was 2.3 (range, 1-4). Median visual acuity at final follow-up (mean, 537±354 days) was 3/60. CONCLUSIONS Chemical injuries in pediatric patients are more commonly encountered in the preschool age group and are associated with severe visual loss. Alkali injury from bursting of chuna packets was the most common mode of injury in pediatric patients in our study.
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Affiliation(s)
- Rasik B Vajpayee
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Himanshu Shekhar
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Jhanji
- Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia; Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong SAR
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Fitzgerald S, Chen X, Qu H, Sheff MG. Occupational injury among migrant workers in China: a systematic review. Inj Prev 2013; 19:348-54. [PMID: 23710065 DOI: 10.1136/injuryprev-2012-040578] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This review considers the state of occupational injury surveillance and prevention among migrant workers in China and suggests areas of focus for future research on the topic. METHODS Bibliographic databases were searched for qualitative and quantitative studies on surveillance of and interventions to prevent occupational injury among migrant workers in mainland China. Additional abstracts were identified from the citations of relevant articles from the database search. Studies fitting the inclusion criteria were evaluated, and findings were extracted and summarised. RESULTS The search uncovered 726 studies in the English-language databases searched, and 3109 in the Chinese database. This article analyses a total of 19 research articles that fit the inclusion criteria with qualitative or quantitative data on occupational injury surveillance and prevention of migrant workers in China. Despite evidence of the vulnerability of migrant workers in the workplace, there is little systematic surveillance of occupational injury and few evaluated interventions. CONCLUSIONS Migrant workers account for a disproportionate burden of occupational injury morbidity and mortality in China. However, data are inconsistent and inadequate to detail injury incidence or to evaluate interventions. The following are suggestions to decrease injury incidence among migrants: strengthen the national system of occupational injury surveillance; focus surveillance and interventions on high-risk occupations employing migrants such as construction, manufacturing and small mining operations; improve occupational safety training and access to appropriate safety equipment; evaluate recent changes in occupational health and safety and evaluate outcome of multi-party interventions to reduce occupational injury among migrant workers.
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Affiliation(s)
- Simon Fitzgerald
- Department of Surgery, Mount Sinai School of Medicine, , New York, New York, USA
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Sahin C, Ergun O, Bayram Y. Burn caused by rinse aid. Burns 2013; 39:538. [DOI: 10.1016/j.burns.2012.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
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Sahin C, Sever C, Kulahci Y. An unusual burn caused by toner powder. J Burn Care Res 2013; 34:e118. [PMID: 23128131 DOI: 10.1097/bcr.0b013e3182642a12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Le Q, Chen Y, Wang X, Hong J, Sun X, Xu J. Analysis of medical expenditure and socio-economic status in patients with ocular chemical burns in East China: a retrospective study. BMC Public Health 2012; 12:409. [PMID: 22672729 PMCID: PMC3408343 DOI: 10.1186/1471-2458-12-409] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 06/06/2012] [Indexed: 11/28/2022] Open
Abstract
Background Little has been known regarding the relationship between ocular chemical injury and victims’ medical expenditure, income loss and socio-economic status changes. So we conduct this retrospective cross-sectional study in patients with ocular chemical burns in East China. Methods Fifty-six patients were enrolled and required to complete a self-report questionnaire consisting of the following contents: entire expenditure on medical treatment; the victims’ personal and household per capita income, and income loss caused by the injury; and the changes of socioeconomic status as well. Results The median expense of medical treatment was CNY 40,000 (approximately US$5,900). The medical expenditure rose significantly with increased injury severity, prolonged hospital stay, and increased frequency of surgery. More than half victims (51.8 %, 29/56) paid all or the majority of medical expense by themselves. The expense of only 5 victims was mainly paid by medical insurance, accounting for less than ten percent (8.9 %, 5/56). The victims’ personal and household per capita income both decreased significantly after the injury, with the median reduction being CNY 24,000 and CNY 7,800 (approximately US$3600 and US$1200) per year respectively. The reduction amplitude of personal and household per capita income rose with increased injury severity and prolonged time of care required. The injury caused emotional depression or anxiety in 76.8 % (43/56) victims, and the relationship with their relatives got worse in 51.9 % (29/56) patients. Moreover, only 21.4 % (12/56) patients felt that the whole society gave them care and concern after the injury, whereas 46.4 % (26/56) and 28.6 % (16/56) felt indifference or discrimination from society as a whole (X2 = 16.916, P = 0.028). Conclusions The medical expense was a huge economic burden to most victims of ocular chemical burns, and personal and household per capita income of the victims decreased significantly after injury, both of which had a close relationship with the injury severity. Formal legislation was urgently needed to compel the employer to purchase injury or medical insurance and provide more compulsory protection to the population working in high risk occupations. In addition, psychological counseling and instruction shouldn’t be neglected in the aid and treatment of victims.
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Affiliation(s)
- Qihua Le
- Department of Ophthalmology, Eye & ENT Hospital of Fudan University, No, 83 Fenyang Road, Shanghai 200031, China
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Hardwicke J, Hunter T, Staruch R, Moiemen N. Chemical burns – An historical comparison and review of the literature. Burns 2012; 38:383-7. [DOI: 10.1016/j.burns.2011.09.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Revised: 09/11/2011] [Accepted: 09/16/2011] [Indexed: 11/25/2022]
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Touzopoulos P, Zarogoulidis P, Mitrakas A, Karanikas M, Milothridis P, Matthaios D, Kouroumichakis I, Proikaki S, Pavlioglou P, Katsikogiannis N, Constantinidis TC. Occupational chemical burns: a 2-year experience in the emergency department. J Multidiscip Healthc 2011; 4:349-52. [PMID: 22096339 PMCID: PMC3210074 DOI: 10.2147/jmdh.s25141] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Indexed: 11/23/2022] Open
Abstract
Chemical burn injuries are a result of exposure to acid, alkali, or organic compounds. In this retrospective study, a total of 21 patients suffering occupational chemical burns, came to the emergency room at the University General Hospital of Alexandroupolis, from 2008 to 2010; 76.2% were workers, 19% were farmers, and 4.8% were desk officers. The majority of burns were due to exposure to acid (61.9%). Upper extremities were the most frequently injured area followed by the lower extremities and thorax. None of the patients needed further hospital care, but in the follow-up, four of the patients suffered keloid. Proper surgical treatment at the emergency room decreases the length of hospital stay for patients who suffer chemically induced burns.
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Affiliation(s)
- Panagiotis Touzopoulos
- 1st University Surgical Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis
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Zhang YH, Han CM, Chen GX, Ye CJ, Jiang RM, Liu LP, Ni LF. Factors associated with chemical burns in Zhejiang province, China: an epidemiological study. BMC Public Health 2011; 11:746. [PMID: 21958110 PMCID: PMC3196712 DOI: 10.1186/1471-2458-11-746] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Accepted: 09/30/2011] [Indexed: 11/10/2022] Open
Abstract
Background Work-related burns are common among occupational injuries. Zhejiang Province is an industrial area with a high incidence of chemical burns. We aimed to survey epidemiological features of chemical burns in Zhejiang province to determine associated factors and acquire data for developing a strategy to prevent and treat chemical burns. Methods Questionnaires were developed, reviewed and validated by experts, and sent to 25 hospitals in Zhejiang province to prospectively collect data of 492 chemical burn patients admitted during one year from Sept. 1, 2008 to Aug. 31, 2009. Questions included victims' characteristics and general condition, injury location, causes of accident, causative chemicals, total body surface area burn, concomitant injuries, employee safety training, and awareness level of protective measures. Surveys were completed for each of burn patients by burn department personnel who interviewed the hospitalized patients. Results In this study, 417 victims (87.61%) got chemical burn at work, of which 355 victims (74.58%) worked in private or individual enterprises. Most frequent chemicals involved were hydrofluoric acid and sulfuric acid. Main causes of chemical injury accidents were inappropriate operation of equipment or handling of chemicals and absence of or failure to use effective individual protection. Conclusions Most chemical burns are preventable occupational injuries that can be attributed to inappropriate operation of equipment or handling of chemicals, lack of employee awareness about appropriate action and lack of effective protective equipment and training. Emphasis on safety education and protection for workers may help protect workers and prevent chemical burns.
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Affiliation(s)
- Yuan H Zhang
- Zhejiang Quhua Hospital, No. 62, Wenchang Road, Quhua District, Quzhou,Zhejiang Province, 324004, China
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Clinical characteristics and visual outcome of severe ocular chemical injuries in Shanghai. Ophthalmology 2010; 117:2268-72. [PMID: 20591491 DOI: 10.1016/j.ophtha.2010.03.050] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2009] [Revised: 03/18/2010] [Accepted: 03/23/2010] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To study the clinical characteristics of patients with severe ocular chemical injury in Shanghai and to determine their relationship with visual outcome. DESIGN Retrospective case series. PARTICIPANTS A total of 79 525 in-patients at Shanghai Eye, Ear, Nose, and Throat Hospital between 1998 and 2008. METHODS Medical records of severe ocular chemical injuries were reviewed retrospectively. Patients' age, gender, occupation, location where injury occurred, the nature of chemical agent, complication, and visual acuity at final follow-up were described. The relationship between visual impairment and clinical characteristics was analyzed. MAIN OUTCOME MEASURES Estimated prevalence rate, demographics of patients, nature of injury, prognosis, and factors associated with visual impairment. RESULTS The estimated prevalence rate in Shanghai of severe ocular chemical injury was 1.58 per 100,000. One hundred ninety cases with 239 eyes were identified for analyzing the clinical characteristics. The average age of all subjects was 35.3 ± 14.8 years with a male:female ratio of 6:1. Factory and construction worker (n = 141; 74.2% of total cases) were the most common occupations. Most of the accidents occurred at workplace (n = 144; 74.8%); the majority of injuries were caused by alkali agents (n = 129; 67.9%). Complications were found in 222 eyes (92.9%). A visual acuity of ≥ 6/60 was achieved only in 5 eyes (2.1%). In multivariate logistic regression analysis, being visually impaired was significantly associated with the patients' complication (P = 0.021). CONCLUSIONS The prevalence of severe ocular chemical injury in Shanghai is low. Most subjects needed surgery to restore visual function. Successful management provides a good prognosis for most patients.
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Milton R, Mathieu L, Hall AH, Maibach HI. Chemical assault and skin/eye burns: two representative cases, report from the Acid Survivors Foundation, and literature review. Burns 2010; 36:924-32. [PMID: 20080356 DOI: 10.1016/j.burns.2009.10.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 10/23/2009] [Accepted: 10/26/2009] [Indexed: 10/20/2022]
Abstract
Chemical assault is a significant problem throughout the world, resulting in disfigurement, sometime blindness or vision impairment, and constituting a major economic burden on otherwise overwhelmed health services in developing countries. Two representative cases are presented here. One involved domestic spouse abuse with an acid and the second involved a teen-aged female assaulted with an acid, perhaps for retribution over a local judicial matter. Such atrocities have a world-wide scope, which is reviewed here. Preventive measures are the most appropriate response. However, when such chemical assaults do occur, active measures to mitigate or negate their effects deserve consideration.
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Palao R, Monge I, Ruiz M, Barret JP. Chemical burns: pathophysiology and treatment. Burns 2009; 36:295-304. [PMID: 19864073 DOI: 10.1016/j.burns.2009.07.009] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Revised: 05/21/2009] [Accepted: 07/13/2009] [Indexed: 12/13/2022]
Abstract
Chemical burns continue to pose a variety of dilemmas to the clinician managing such cases. Assessment of burn depth is often difficult and the decision whether to excise the wound early is not always clear-cut. In this updated review, common agents are classified and the basic principles of management and specific recommendations are examined. The complications arising from exposure to these chemicals and the supportive measures needed during treatment are also described.
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Affiliation(s)
- R Palao
- Burn Centre, Department of Plastic Surgery and Burns, University Hospital Vall d' Hebron, Universitat Autònoma de Barcelona, Passeig de la Vall d'hebron, Barcelona, Spain.
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Maghsoudi H, Gabraely N. Epidemiology and outcome of 121 cases of chemical burn in East Azarbaijan province, Iran. Injury 2008; 39:1042-6. [PMID: 18656194 DOI: 10.1016/j.injury.2008.03.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2008] [Revised: 03/12/2008] [Accepted: 03/20/2008] [Indexed: 02/02/2023]
Abstract
AIM To explore the epidemiology, mechanisms, complications, morbidity and mortality associated with chemical burns. METHODS Data from 121 cases of chemical burn treated in our department over a 5-year period were compared. Data were obtained by prospective proforma. RESULTS A mean 7.98% of total body surface area was burned. This series had a male:female ratio of 10:1, with a mean age 35.3 years. Young men experiencing work-related accidents were the most frequent victims. The majority of chemical burns occurred away from home (98.3%), particularly in the working environment (78.5%); 111 (91.7%) burns were accidental and 10 (8.3%) constituted criminal assault. Tar was the most frequent agent involved, followed by acid, and the hands were the most frequent site of injury. Most burns were small and of second degree; 10.7% of cases involved serious ocular damage. The mean hospital stay was 10 days, and the mortality rate was 1.7%. CONCLUSIONS Constant safety education for the public and professional training for workers would reduce the incidence of chemical burns. Prevention strategies must be coordinated on a national level.
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Affiliation(s)
- Hemmat Maghsoudi
- Department of Surgery, Faculty of Medicine, University of Medical Sciences of Tabriz, Tabriz, Iast Azarbaijan, Iran.
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Yongqiang F, Yibing W, Dechang W, Baohua L, Mingqing W, Ran H. Epidemiology of Hospitalized Burn Patients in Shandong Province: 2001–2005. J Burn Care Res 2007; 28:468-73. [PMID: 17438493 DOI: 10.1097/bcr.0b013e318053d28b] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The aim of the article was to describe the epidemiology of burn injuries requiring hospitalization at Shandong Provincial Hospital and to provide information necessary for the design and implementation of effective prevention programs. The records of patients with burn injury admitted to our burn unit over a 5-year period (1 January 2001 to 31 December 2005) were reviewed. Medical record review provided basic demographic information and details on the extent of injury, time of day burns occurred, month of admission, cause of burn, accident site, first aid, number of operations, length of hospital stay, and mortality. There was no trend in annual admissions. The male-to-female ratio was 3:1. The age distribution of burn patients showed peaks occurring at the age groups of 0 to 10 and 20 to 30 years. Over the course of a day, burn injuries occurred most frequently from 1700 to 1900 hours. Scalds accounted for 45.23% (502) of the 1110 patients, and flame burns accounted for 42.33% (471). Only 29% of all patients received proper first aid with cool water or burn cream. The average length of hospital stay was 22 days. Children under 10 years and adults between 20 and 30 years of age are the most susceptible populations, and first aid is performed poorly in Shandong Province. Burn prevention and first aid education campaigns should be launched to encourage safe lifestyle and work habits.
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Affiliation(s)
- Feng Yongqiang
- Department of Burn & Plastic Surgery, Shandong Provincial Hospital, Shandong University, Jinan 250021, China
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Mannan A, Ghani S, Clarke A, Butler PEM. Cases of chemical assault worldwide: A literature review. Burns 2007; 33:149-54. [PMID: 17095164 DOI: 10.1016/j.burns.2006.05.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2005] [Accepted: 05/19/2006] [Indexed: 12/01/2022]
Abstract
We reviewed 24 studies of chemical burns by means of assault in the last 40 years. We describe 771 cases of chemical assault in total. Jamaica had the largest absolute number of cases. Bangladesh had the highest reported incidence. Male victims were more common, with the exception of Bangladesh and Taiwan. The youngest cohort was from Bangladesh. The role of gender, agents used and legislation were discussed. We identified two broad motives; increases in violent crime and use as a crime of passion in disputes between men and women.
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Affiliation(s)
- Ashim Mannan
- Royal Surrey County Hospital, Guildford, Surrey, UK.
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Tang K, Jian L, Qin Z, Zhenjiang L, Gomez M, Beveridge M. Characteristics of burn patients at a major burn center in Shanghai. Burns 2006; 32:1037-43. [PMID: 17011133 DOI: 10.1016/j.burns.2006.03.021] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2005] [Accepted: 03/31/2006] [Indexed: 11/23/2022]
Abstract
In China, burns are becoming a major cause of morbidity and mortality with large societal and economic implications. To date, there is little epidemiological data on burns in China to direct prevention efforts. This study describes the characteristics of burn patients admitted to a major burn center in Shanghai using a burn registry developed in Toronto, Canada. A retrospective review of burn patients discharged from the Shanghai's Rui Jin Hospital Burn Unit, between March 1st 2002 and April 30th 2003, was conducted. Of 527 patients discharged, 307 were acute burn patients and 302 (98.4%) had complete data to be included in the study. There were 214 (71%) males and 88 (29%) females with a male to female ratio of 2.4:1. The median age was 30 years, and the median total body surface area burned was 10%. The majority of burns occurred at work (58%), and the most frequent etiology was flames (39%) followed by scalds (31%) and contact with hot objects (15%). Sixteen (5%) patients had inhalation injury and six (2%) patients died. There were 70 (23%) children (0-14 years), 221 (73%) adults (15-59 years) and 11 (4%) seniors (60 years and above). Children had more scald burns (83%) and the majority (83%) occurred at home. Adults had more flame burns (46%) and the majority (79%) were work-related injuries. Seniors had more flame burns (73%) and the majority (55%) occurred in domestic incidents. Seniors had deeper burns (13%, p=0.005), required more escharotomies (55%, p=0.002), required more operations (2, p=0.051) and had higher mortality (36%, p<0.001) than other age groups. These results provide compelling evidence for performing population-based studies to identify risk factors that are susceptible to modification in each age group.
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Affiliation(s)
- Keith Tang
- University of Toronto, Faculty of Medicine, Toronto, Canada
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Echevarría-Guanilo ME, Rossi LA, Dantas RAS, Dos Santos CB. Cross-cultural adaptation of the Burns Specific Pain Anxiety Scale - BSPAS to be used with Brazilian burned patients. Rev Lat Am Enfermagem 2006; 14:526-33. [PMID: 16967158 DOI: 10.1590/s0104-11692006000400009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2005] [Accepted: 01/12/2006] [Indexed: 11/22/2022] Open
Abstract
This study aimed at translating and adapting the Burns Specific Pain Anxiety Scale - BSPAS and the Impact of Event Scale - IES into Portuguese; making available two simple, short and easily applicable instruments and describing the study participants according to their scores on the Visual Analogue Scale and the Trait-State Anxiety Inventory. The cross-cultural adaptation process involved the following steps: translation of the scales; reaching a consensus in Portuguese; evaluation by an expert committee; back-translation; obtaining a consensus in Dutch; comparing the original versions with the consensus in Dutch; semantic analysis and pretest of the Portuguese versions. The results showed that both scales present high values of internal consistency between the scale items. Participants' average pain scores were higher after bathing and wound dressing. Participants' average anxiety scores were low or medium.
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Rawlins JM, Khan AA, Shenton AF, Sharpe DT. Burn patterns of Asian ethnic minorities living in West Yorkshire, UK. Burns 2006; 32:97-103. [PMID: 16378691 DOI: 10.1016/j.burns.2005.08.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2005] [Accepted: 08/11/2005] [Indexed: 10/25/2022]
Abstract
Whereas burn morbidity and mortality have been well studied among natives of Southeast Asia, few have studied the epidemiology of burn injury among UK Asian ethnic minority immigrants. A 1 year prospective study of all patients presenting with burns to Bradford Royal Infirmary was carried out. Four hundred and sixty patients were studied, 188 (41%) were Asian ethnic minorities. The average patient age was 17 years for the Asian group and 27 years for the non-Asian patients. Contact burns were responsible for 29% of injuries in Asian patients and 19% in the other group. Thirty-seven percent of contact burns in the Asian ethnic minority group were caused by hot irons. Eleven percent of Asian patients had treated their burn with inappropriate remedies including saiti, butter, and toothpaste. There were no significant differences between Asian and non-Asian patients in terms of large or deep burns, nor in mortality. Morbidity and mortality from burn injury among UK Asian patients and other groups in the UK are similar; however, a disproportionate number of Asian patients sustain smaller burns. Much of this is behaviour related, and it is hoped that through preventative measures a marked reduction in the number of Asian ethnic minority burns can be achieved.
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Affiliation(s)
- J M Rawlins
- Plastic Surgery and Burns Research Unit, University of Bradford, Richmond Road, Bradford BD7 1 DP, UK.
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Hsieh CH, Lin GT. Corrosive injury from arterial injection of hydrochloric acid. Am J Emerg Med 2005; 23:394-6. [PMID: 15915422 DOI: 10.1016/j.ajem.2005.02.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
This report presents a case of hydrochloric acid injection in the inguinal area in a suicide attempt, resulting in total occlusion of the external iliac artery, requiring disarticulation of the hip. To the authors' best knowledge, it has not been previously reported in the English medical literature. The accelerated destructive activity of these irritant chemicals and deep tissue damages are emphasized. Early and aggressive debridement with copious saline irrigation and circumspect monitoring are recommended.
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Affiliation(s)
- Chih-Hsin Hsieh
- Department of Orthopaedic Surgery and Trauma, Kaohsiung Medical University, Taiwan
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