Treatment Of Hydrofluoric Acid Burns Research Articles

Research advances on the treatment of hydrofluoric acid burns

Hydrofluoric acid is a highly dangerous and toxic inorganic acid, which is widely used in industrial fields and daily life. The risk of hydrofluoric acid burns is related to hydrofluoric acid mass fraction, duration of exposure to hydrofluoric acid, burn area, burn depth, and burn site, etc. Hydrofluoric acid has strong toxicity and tissue penetration ability. A small area of hydrofluoric acid burns can cause death in a short time. Therefore, improving the understanding of the mechanism of hydrofluoric acid burns and learning how to treat hydrofluoric acid burns in different sites can further improve the cure rate of hydrofluoric acid burns.

Hydrofluoric Acid Burns: A Case Report

Hydrofluoric (HF) acid has numerous uses both in industry and the home. HF burns are characterized by intense pain, progressive tissue damage and significant systemic effects. Pain may be prolonged because the fluoride ion remains active despite irrigation of the burn. Subcutaneous infiltration of calcium gluconate is the local treatment of choice. We present a case of hydrofluoric acid burn from rust remover that was effectively treated by topical calcium gluconate baths. A calcium gluconate solution can be prepared with material available in most hospitals and may be readily administered in this fashion. Early recognition and appropriate treatment of hydrofluoric acid burns will provide symptomatic relief and minimize tissue damage.

The treatment of hydrofluoric acid burns.

Hydrofluoric acid is a colourless or almost colourless, fuming liquid having a highly caustic and corrosive effect on organic tissue. Many kinds of hydrofluoric acid in concentrations are used in Industrial processes and laboratory uses because of its useful chemical properties. Hydrofluoric acid causes severe and painful burns to the skin and eyes. In this paper, the immediate symptoms, the typical treatments in the literature, first aid and therapy of hydrofluoric acid burns are reviewed.

An algorithmic approach to the treatment of hydrofluoric acid burns

Hydrofluoric acid (HF) injuries have a potential for both systemic toxicity as well as severe tissue destruction. We present an algorithm for the management of HF burns. This algorithm addresses these issues emphasizing the differences between major and minor cutaneous burns, and includes the approach to inhalation, ingestion and eye injuries. Although algorithms can never be complete, we hope this algorithm will be used as an aid in the clinical management of these patients.

Comparison of Topical Magnesium and Calcium Treatment for Dermal Hydrofluoric Acid Burns

Study objective: To compare topical preparations of magnesium and calcium in the treatment of dermal hydrofluoric acid burns. Design: A randomized, blinded, controlled animal model study. Setting: Animal care facility. Type of participants: New Zealand rabbits. Interventions: Each rabbit was burned with hydrofluoric acid at four sites along the thoracolumbar spine. Equimolar amounts of calcium gluconate, magnesium gluconate, and a magnesium hydroxide antacid were added into a lubricating jelly. The jelly alone was a control preparation. After a water rinse, the burns were massaged with the gels for 1 minute five times; at 4 and 20 minutes and at 1, 4, and 24 hours. Each rabbit served as its own control by receiving all four treatments. Measurements and main results: Burn diameter and burn surface area diminished over time, but there were no statistically significantly differences among the treatments. Burn ranking and burn rating of severity also did not demonstrate differences. The histologic analysis of the burns, however, demonstrated that calcium gluconate-treated burns were less severe and more superficial than the control and magnesium gluconate-treated burns; the magnesium hydroxide antacid-treated burns were not statistically different compared to the calcium gluconate-treated burns. Conclusion: Topical calcium gluconate is an efficacious treatment for dermal hydrofluoric acid burns. Further research is needed to determine the role of magnesium-containing antacids in the treatment of hydrofluoric acid burns. [Burkhart KK, Brent J, Kirk MA, Baker DC, Kulig KW: Comparison of topical magnesium and calcium treatment for dermal hydrofluoric acid burns. Ann Emerg Med July 1994;24:9-13.]

Intravenous magnesium in the treatment of hydrofluoric acid burns in rats

To gather preliminary data on the safety and efficacy of IV magnesium in a rat model of hydrofluoric acid burns. Forty-seven anesthetized male rats (200 to 300 g) received a standardized burn with 52% hydrofluoric acid. Animals were anesthetized with 30 to 50 mg/kg ketamine IM and 1 to 3 mg/kg xylazine IM. A standardized chemical burn was created by topical application of 52% hydrofluoric acid. The rats were divided into four treatment groups: group 1 received no treatment; group 2 received intradermal injection of 10% calcium gluconate; group 3 received 80 mg/kg MgSO4 IV; and group 4 received 160 mg/kg MgSO4 IV. After the rats were killed, the burn lesions were excised and examined by a pathologist to determine the grade of burn (which was equal to the clinical degree of burn). Microscopic examination of the burns revealed differences among the four groups. Five of 13 group 1 rats (37%) died within 24 hours of burn initiation. Of group 1 survivors, 50% had grade 2 burns, and the other 50% had grade 3 burns. In group 2, eight of 11 rats (73%) had grade 3 burns. Twenty-five percent of group 3 rats (three of 12) had grade 3 burns, and only 9% of group 4 rats (one of 11) had grade 3 burns. Only the difference in the rates of grade 3 burns for groups 2 and 4 was statistically significant. Although not statistically significant, burns in groups 3 and 4 tended to be smaller in diameter than burns in groups 1 and 2. High-dose IV magnesium sulfate reduces the severity of hydrofluoric acid burn compared with conventional intradermal calcium gluconate therapy. Early deaths appeared to be prevented by both calcium and magnesium therapies.

Evaluation of Intravenous Magnesium Sulfate for the Treatment of Hydrofluoric Acid Burns

Hydrofluoric acid exposures to the skin can produce severe, progressive burns. Medical treatment of these burns is aimed at neutralizing the free fluoride ion, which is felt to be responsible for burn progression. Both calcium and magnesium will form complexes with free fluoride and have been used as topical or intradermal treatments in the past. This study evaluated the efficacy of intravenous magnesium sulfate for the treatment of hydrofluoric acid burns and compared this treatment to controls and burns treated with intradermal calcium gluconate in a rabbit model. Both treatments demonstrated a reduction in burn area over time, wound depth, healing time and final scar area compared to controls. The intravenous magnesium treatment showed trends toward improved outcome compared to the intradermal calcium treatment in all parameters evaluated, but these differences did not reach statistical significance. This investigation found intravenous magnesium to be an effective method for treating hydrofluoric acid burns. Intravenous magnesium may have significant utility for treating hydrofluoric acid burns that are not amenable to current therapies.

An experimental study on the treatment of hydrofluoric acid burns.

A 20% solution of hydrofluoric acid (HF) was applied to the skin of rats and a biomedical observation of the tissues and sera was made. Flushing with running water was effective for HF burns. By applying 2.5% calcium gluconate jelly, concentrations of fluoride in the urine and the tissues surrounding the injured region were reduced. Thus, the results proved that irrigation with running water and jelly applications were evaluated as the most effective therapy among various methods tested for HF burns.

Intra-arterial infusions in the treatment of hydrofluoric acid burns

Burns due to hydrofluoric acid are uncommon, but are severe injuries. The mode of action is discussed briefly and the routine management of these patients is outlined. The use of intra-arterial infusions of calcium gluconate is stressed, and case reports are given to support its use.

Hydrofluoric acid burns of the hand

Hydrofluoride burns of the hand are evaluated from physiologic and treatment aspects, and two case reports are presented. An uncommon complication of hydrofluoric acid burns of the hand is presented as reflex sympathetic dystrophy. Initial treatment of hydrofluoric acid burns of the hand involves debridement of the burn and calcium gluconate injections locally into the area. Burns involving the nail bed frequently necessitate removal of the nail for proper treatment.

Hydrofluoric Acid Burns of the Hand

Hydrofluoride burns of the hand are evaluated from physiologic and treatment aspects, and two case reports are presented. An uncommon complication of hydrofluoric acid burns of the hand is presented as reflex sympathetic dystrophy. Initial treatment of hydrofluoric acid burns of the hand involves debridement of the burn and calcium gluconate injections locally into the area. Burns involving the nail bed frequently necessitate removal of the nail for proper treatment.

Treatment for hydrofluoric acid burns

Abstract Various approaches to HF burn have been studied. This presentation offers a somewhat different approach which centres around the use of benzethonium chloride solution and betamethasone. A review of 10 case records confirms the effectiveness of this treatment when compared to that in prior use, especially in the treatment of an emergency.

Hydrofluoric acid burns. A report of a case and review of the literature

Burns caused by exposure to hydrofluoric acid are occurring with ever-increasing frequency due to the wide use of this acid in industry and research. Such burns are characterized by severe progressive tissue destruction and excruciating pain resulting from the unique properties of the freely dissociable fluoride ion. The subungual tissues are especially susceptible to the destructive effects of hydrofluoric acid. The proper treatment of hydrofluoric acid burns requires prompt recognition and the institution of specific therapeutic measures by the attending physician.

Treatment of hydrofluoric acid burns of the fingers. (German)

Treatment of hydrofluoric acid burns of the fingers. (German)

Rationale of the treatment of hydrofluoric acid burns.

<b>Carney, Shirley A., Hall, M., Lawrence, J. C., and Ricketts, C. R. (1974).</b><i>British Journal of Industrial Medicine,</i><b>31,</b> 317-321. <b>Rationale of the treatment of hydrofluoric acid burns.</b> On contact with skin hydrofluoric acid yields hydrogen and fluoride ions, which exhaust the tissue9s buffering capacity. Fluoride was found to be toxic to skin cells, as judged by the accumulation of 3-phosphoglycerate (3-PG), at about 2 × 10^-3 mol/l fluoride ion in the medium on which skin slices were maintained. This toxicity was reversible by the dilution brought about by transfer of the skin to a fresh medium; 3-PG levels fell and tetrazolium reductase measurements showed adequate viability. Using a specific ion electrode for fluoride, the efficacy of calcium, magnesium and lanthanum salts and hyamine in lowering fluoride ion concentration in the presence of serum was examined. Lanthanum was the most effective but was itself toxic to skin cells as judged by respiration and tetrazolium reductase measurements. Calcium appeared more effective as chloride than as gluconate. Magnesium and hyamine were ineffective under the conditions of experiment. In the presence of serum, calcium gluconate is only just capable of lowering the concentration of fluoride ions to the level at which their toxic effect is negligible. The importance of rapid removal of hydrofluoric acid from the skin surface as a first-aid treatment is emphasized.