Early debridement combined with antidote in the treatment of one patient with chromic acid burn and acute kidney injury

Abstract

On November 16, 2018, one male patient, aged 52 years was admitted to Northern Jiangsu People's Hospital due to thermal chemical burn to the right lower limb for 1 hour. The total burn area reached 9% total body surface area (TBSA), including 7%TBSA of partial-thickness burn and 2% TBSA of full-thickness burn. After admission, the patient was treated with anti-infection, analgesia, fluid infusion. On November 19, the patient developed symptoms such as nausea, vomiting, and oliguria, the related laboratory examination showed acute kidney injury, and the patient was immediately treated with continuous renal replacement therapy. Eschar excision, eschar cutting and shaving, skin grafting were performed on 20 and 27 November, and the specific antidote was applied. After active treatment, the patient's condition was gradually stable and recovered, and he was discharged 2 months later. There was no obvious abnormality during follow-up of 5 months after discharge. This case reminds that clinicians shall strengthen the understanding of chromic acid burns, especially for the patient combined with thermal burns, timely and effective treatment of wounds after burns, close monitoring of liver and kidney function and blood chromium concentration, and early application of antidote are necessary.