Chemical Burn Injuries

Chemical burns often develop after exposure to corrosive substances. They include 10.7% of all burn types and 2-6% of the patient admissions to the burn center. Chemical compounds possess 6 different types of damaging mechanisms; reduction, oxidation, corrosion, protoplasmic toxins, vesicants and desiccants. The characteristics of chemical burn injuries include skin discoloration and contractures, having rarely regular shape, perforation in the gastrointestinal tract with the risk of severe systemic toxicity and mortality. Compared to the thermal burns, the wound healing process following chemical burn injuries is markedly slower and also frequently related with a prolonged stay at the hospital. Moreover, generally the burn injury results following a prolonged exposure to the chemical agent. White phosphorus burns are good examples for this process. It should be considered in presence of burns with progressive necrosis. Emergency resuscitation is crucial for the management of injury. Most frequently observed agents in home injuries are liquid ammoniac and nitric acid. For chemical burn injuries the gold standart of treatment still is the irrigation of the wound with a copious amount of water. It is important to take protective measures in order to reduce the prevalence of chemical burn injury. Nation-wide campaigns with full support from the media are needed to raise awareness of the general population and preventive strategies. Public service broadcastings, media organs, trade unions, physicians and patients should work together for this purpose.

Kimyasal Yanýklar

Kimyasal yanýklar sýklýkla koroziv maddelere maruziyet sonrasýnda geliþmektedirler. Tüm yanýk türlerinin %10,7’sini, yanýk merkezine hasta kabullerinin de %2-6’sýný oluþturmaktadýr. Kimyasal komponentlere baðlý hasar 6 farklý mekanizmayla ortaya çýkmaktadýr. Bunlar redüksyon, oksidasyon, korozyon, protoplazmik toksinler, yakýcý kimyasallar ve kurutuculardýr. Kimyasal yanýk hasarýnýn karakteristikleri arasýnda ciltte renk deðiþiklikleri ve korozyon, nadiren regüler bir yapý, gastrointestinal kanalda perforasyon, ciddi sistemik toksisite ve mortalite riski yer almaktadýr. Termal yanýklarla karþýlaþtýrýldýðýnda yara iyileþme süreci belirgin derecede daha yavaþ olup sýklýkla hastanede uzamýþ yatýþ süresiyle iliþkilidir. Ayrýca yanýk hasarý genellikle kimyasal ajana uzamýþ maruziyet sonrasýnda oluþmaktadýr. Beyaz fosfor yanýklarý bunun iyi bir örneðidir. Progresif nekroz geliþen yanýklarýn patogenezinde akla getirilmelidir. Acil resusitasyon hasar yönetiminde önceliklidir. Evde oluþan kazalardaysa sýklýkla sebep sývý amonyak ve nitrik asiddir. Kimyasal yanýk hasarý tedavisinde halen altýn standart yeterli miktarda su ile yaranýn irrigasyonudur. Kimyasal yanýk hasarý prevalansýný azaltmaya amaçlý olarak koruyucu önlemlerin alýnmasý önemlidir. Genel nüfus ve önleyici stratejilerin farkýndalýðýný artýrmak için medyanýn tam desteðiyle ülke çapýnda kampanyalara ihtiyaç duyulmaktadýr. Kamu spotlarý, medya organlarý, özel kuruluþlar, hekimler ve hastalar bu amaçla birlikte çalýþmalýdýrlar.