A Case of Non-Operative Management for Sulfuric Acid Burns
It is thought that severe chemical burns usually require a treatment of extended deep skin and subcutaneous tissue debridement and subsequent skin grafting. However, in this report we discuss the successful treatment of a severe dorsal chemical burn caused by sulfuric acid without skin grafting. A 45-year-old man was showered with highly concentrated (80%) sulfuric acid from a pipe burst at a factory. He sustained severe chemical burn injuries to the limbs and back. On arrival at the hospital, total body surface area burned, the burn index, and the prognostic burn index were 61.5%, 57.7, and 102.7, respectively. Considering the patient’s functional prognosis, surgical treatment of the limbs involving skin grafting was performed early in the treatment process. Additionally, daily bedside debridement of necrotic tissue of the back resulted in complete epithelialization without skin grafting. It is difficult to accurately assess the depth of dorsal burns due to the thickness of dorsal skin. In cases of chemical burns, skin color changes associated with chemical reaction make the assessment of burn depth even more difficult. The dorsal burn was estimated to be third degree on arrival in the present case. However, complete epithelialization without skin grafting suggests that it was a second degree burn. The patient was discharged 218 days after injury. The patient’s functional prognosis was satisfactory with soft skin texture and no contractures. doi：10.11482/KMJ-E42（1）9 (Accepted on March 4, 2016)
