Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 6, 2020; 8(7): 1337-1342
Published online Apr 6, 2020. doi: 10.12998/wjcc.v8.i7.1337
Systemic treatment for severe concentrated sulfuric acid burns in an adult male at high altitude: A case report
Ruo-Mei Zhao, Yi Li, Sheng-Wu Chao, Hong-Jin Wang
Ruo-Mei Zhao, The Graduate School Of Qinghai University, Xining 810016, Qinghai Province, China
Yi Li, Sheng-Wu Chao, Hong-Jin Wang, Department of Burns and plastic Surgery, Affiliated Hospital of Qinghai University, Xining 810001, Qinghai Province, China
Author contributions: Wang HJ and Zhao RM were the patient’s attending physician, reviewed the literature and contributed to manuscript drafting, and performed the revision of the manuscript for important intellectual content; Li Y and Chao SW designed and guided surgical procedures; All authors issued final approval for the version to be submitted.
Supported by Qinghai Association for Science and Technology Support Project for Young and Middle-aged Talents in Science and Technology, No. 2019QHSKXRCTJ03.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2013), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Hong-Jin Wang, MD, Associate Professor, Surgeon, Department of Burns and Plastic Surgery, Affiliated Hospital of Qinghai University, Tongren Road No. 29, Xining 810001, Qinghai Province, China. 19685400@qq.com
Received: November 24, 2019
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
Processing time: 134 Days and 4.2 Hours
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: High altitude area; Concentrated sulfuric acid burns; Extensive burn; Case report

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.