Water jet for early treatment of chemical burn

Abstract

The first necessity in the initial management of burn to remove from the wound the agent of burn and also any contaminants, clothes or foreign bodies. This is particularly important in chemical burns, because the agent may penetrate deeply into the skin and cause ongoing tissue destruction unless it is immediately and completely removed by washing or irrigation using saline or water. It is well known that irrigation with water is the most effective way both to neutralise and to remove chemical agents; however, some compounds may penetrate the epidermis and may remain after irrigation, so that tissue damage progresses. Complete removal of necrotic skin and tissue as soon as possible is the next step in burn treatment. This accelerates wound healing with or without dermal substitutes, particularly in superficial injuries. Debridement ideally removes all necrotic tissue in a single procedure, leaving behind viable undamaged tissue. This improves the quality of healing in firstand second-degree burns, and minimises the need for further wound revisions. The water jet system, based on fluid jet technology, has been advocated as an alternative to standard surgical excisional techniques for burn, The water jet is capable of adequately debriding superficial and partial-thickness wounds [1–4]. In this article we report on the use of water jet hydrosurgery in the early treatment of a hydrochloric acid burn.