alkali burn
Introduction
Introduction Commonly used are caustic, ammonia, lime and the like. Alkali can dehydrate tissue cells and saponify fat. Alkali ions combine with proteins to form basic proteins that can penetrate into deep tissues. Therefore, if the early treatment is not timely, the wound can continue to expand or deepen, and cause pain, caustic burn wounds, early flushing or small blisters, generally deep. After the eschar or necrotic tissue falls off, the wound surface is sunken, and the edge sneaked, which often lasted for a long time. It is required to rinse with clean water for a first time after a burn, and it is generally not necessary to use a neutralizing agent.
Cause
Cause
Most of them are caused by skin and other body parts exposed to alkaline substances such as strong alkali. Commonly used are caustic, ammonia, lime and the like. Alkali can dehydrate tissue cells and saponify fat. Alkali ions combine with proteins to form basic proteins that can penetrate into deep tissues.
1. It has a large destructive effect and can dissolve proteins to form alkaline denatured proteins. Tissue protein breakdown is toxic and causes systemic symptoms after absorption.
2. Cause tissue necrosis, soft, brittle, no obvious boundaries, first white and then black, the ulcer formed after shedding is easy to hemorrhage, more difficult to heal than acid burn ulcer, after the formation of scars more acid burns Sexual scars affect the function more clearly.
3. Moderate concentration and low concentration of alkaline solution can only make skin fat saponification without necrosis, and the pathological process is recoverable.
Examine
an examination
Related inspection
Blood examination physical examination of skin color skin disease
(1) A history of direct contact with alkali substances.
(2) The wound surface is brown, the local pain is severe, the alkali can dissolve the tissue protein, and the fat can be saponified, and the heat is generated to continue the necrosis of the deep tissue. Therefore, the alkali burn wound is often progressively deepened.
(3) The vapor of strong alkali substances (such as caustic) has strong stimulation to the eyes and upper respiratory tract, which can cause burns in the eyes and upper respiratory tract. It should be highly vigilant in diagnosis and treatment.
(4) After alkali burns, the tissue damage range is large, the early swelling is obvious, the fluid loss is large, and it is easy to cause shock.
Diagnosis
Differential diagnosis
(1) Hydrofluoric acid burns: The skin is white, gray or gray. The acid is highly penetrating and can reach the bones. After washing with water:
1. Wet or bath with 5% sodium bicarbonate or 3% calcium chloride solution.
2. Topical application of calcium chloride cream (5% calcium chloride 20ml + 2% lidocaine 20ml + dexamethasone 5mg + dimethyl sulfoxide 60ml).
3.10% calcium gluconate 10-20ml wound in the corresponding intra-arterial injection, once a day, for 5-7 days.
4.3% calcium chloride is used for local calcium ion introduction, 1-2 times a day, 20-30 minutes each time.
5. Excision or amputation is performed when the black necrotic tissue is clearly defined.
(2) Chromic acid burn: rinse with running water for 20-30 minutes, externally apply 5% sodium thiosulfate solution or apply 5% sodium thiosulfate ointment, other common burns.
(3) Carbolic acid burn: Because it is insoluble in water, it is soluble in alcohol. Wash the wound with 50%-70% alcohol (not too large), and then wet it with 5% sodium bicarbonate solution. Others are generally burned.
(4) oxalic acid (oxalic acid) burns: After rinsing with water, it can be applied with lime water clear solution or 5% sodium bicarbonate, and the other common burns.
(5) Phenol burn: first rinse with water for 20-30 minutes, then wash with 50%-70% alcohol, then rinse with water; or repeatedly rinse with glycerin and alcohol mixture (7:3) for 10-15 minutes, then Rinse with water; or wet with saturated sodium sulphate or 5% sodium bicarbonate for 60 minutes, then rinse with water until no phenolic taste, other common burns.
