Major chemical burn injury combined with a penetrating injury of the abdomen leading to hypovolemic shock

SummaryA chemical burn is a specific type of lesion and represents a small proportion of all cutaneous burns. The incidence of such burns can be as high as 10.7%, and they account for up to 30% of all burn deaths. They require individualized treatment and management depending on the causative agent. Sometimes, a chemical burn might be complicated with other major forms of trauma, making it more difficult to manage. This report details the successful treatment of a major sulfuric acid burn complicated with an abdominal penetrating injury leading to hypovolemic shock. A 38-year-old woman presented with major second- and third-degree chemical burn injuries over her chin, anterior chest, and both upper limbs. The burns covered approximately 15% of her total body surface area and were combined with an abdominal penetrating injury and hypovolemic shock. Emergency damage control surgery was performed to stabilize the patient's vital signs. Second-stage reconstruction and debridement with skin grafting was performed when the patient had reached a relatively stable condition. At a 1-year follow-up, the patient had recovered well, capable of full-range motion over her neck and in both upper limbs and exhibiting no scar contracture. The combination of a chemical burn and trauma has a high potential morbidity and mortality rate. The initial management of this condition involves stabilization and resuscitation, as in the management of traumas without burn injuries. Damage control surgery with intensive care is the most urgent, followed by management of the burn wounds. After immediate treatment, management strategies are considerably similar for chemical and thermal burns.