Seventy Per Cent Hydrofluoric Acid Burns: Delayed Decontamination With Hexafluorine® and Treatment With Calcium Gluconate

Abstract

This is a case report of decontamination and treatment of a 70% hydrofluoric acid (HF) dermal splash injury. A worker was splashed with 70% HF, sustaining approximately 10% TBSA first- to third-degree chemical skin burns of the face, trunk, and left thigh and leg. Initial decontamination involved water rinsing, removal of contaminated clothing, more water rinsing, topical application of magnesium oxide, and administration of intravenous narcotics for management of severe pain. After a delay of approximately 3 hours, active skin washing with Hexafluorine®, 5 L, was performed, followed by intravenous, intradermal perilesional, and topical inunction administration of calcium gluconate. Pain relief and a cooling sensation were quite prompt after Hexafluorine® decontamination. Surgical debridement and skin grafting of the more severe burns were required. No significant systemic toxicity developed, although this has occurred in previously reported similar concentrated HF dermal splash exposure cases, some of which resulted in fatality. While burns did develop, the patient was released from the intensive care service after 2 days and, after skin grafting, had a good outcome at 90-day follow-up. Even after a long delay, decontamination with Hexafluorine® appeared to be beneficial in this case.