Published online Apr 6, 2020. doi: 10.12998/wjcc.v8.i7.1337
Peer-review started: November 24, 2019
First decision: December 30, 2019
Revised: February 11, 2020
Accepted: March 5, 2020
Article in press: March 5, 2020
Published online: April 6, 2020
The aim of this study was to report a case of a patient who suffered from severe concentrated sulfuric acid burns while working at high altitude. This patient recovered after systemic treatment. We also provide a literature review for a better understanding of the disease.
A 30-year-old male, who was working in a local chemical plant in Xining (the Qinghai provincial capital, China) at an altitude of 2261 m, suffered from burns 85% TBSA (III° 70%TBSA, deep II° 15%TBSA) after a tank containing 80% concentration of sulfuric acid exploded. The patient immediately received a series of first aid treatments, as well as rigorous wound managements after admission, which included protection for the whole body and organs, prevention and treatment of eye burns, and the appropriate oxygen therapy. After 65 d of treatment, the burn wounds had completely healed, and the patient was transferred to another specialized hospital for further eye treatment. The first aid before admission and the emergency treatment of wounds following admission were appropriate. No severe complications of sepsis, severe renal insufficiency, septic costal chondritis, corneal perforation or other burns occurred during the treatment.
The main causes of concentrated sulfuric acid burns consisted of accidental burns at work, accidents in the outside, factitious injuries and improper laboratory operations. The clinical manifestations were mostly deep II° and III° burns, with a formation of brown-black, leather-like eschar on the wound surface and locally embolized dendrite-like vessels. The clear cause of the injury and typical clinical manifestations in this case made it easy to diagnosis. However, adult cases with severe concentrated sulfuric acid burns in high altitude areas are rare, so the successful treatment of this case is of great significance.
Core tip: Severe concentrated sulfuric acid burns are rare in the world. We herein present a rare case of extensive concentrated sulfuric acid burns caused by a tank in a factory containing an 80% concentration of sulfuric acid. The worker received a series of treatments that included first aid immediately following the burn, as well as rigorous wound managements after admission, which included protection for the whole body and organs, prevention and treatment of eye burns, and the appropriate oxygen therapy. After the 65-d of treatments, the burn wounds completely healed, and the patient was transferred to another specialized hospital for further eye treatment.