Chemical burns: A review

SummaryChemical burns form a significant percentage of mortality from burns and total burns cases reported. There are over 65,000 chemicals available on the market, a large number of which can cause tissue damage. Despite this, they are often mismanaged. The severity of the chemical burn is dictated by the substance responsible, the percentage burn, the concentration, time since exposure, subsequent management and regional skin properties. Burns can be caused by both acids and alkalis. Acid burns cause eschars which limit the extent of the burn. Alkali burns therefore tend to be deeper. Like all burns, the patient should be resuscitated according to the Adult Trauma Life Support guidelines. Copious irrigation forms the mainstay of treatment. Neutralising agents are present for certain chemicals but their use should not delay the irrigation process which may take several hours. We look at the most common chemicals encountered in daily life and explore special considerations when dealing with resulting burns. Chemical burns are often associated with other injuries such as inhalation injury, so it is essential that the patient is considered holistically and all other injuries considered before concentrating all efforts on the chemical burn alone.