TITLE:
Serious Burn by Sulfuric Acid: Case Report of Particular Therapeutic Strategy in a Non-Specialized ICU at Hôpital Principal de Dakar (HPD) Sénégal
AUTHORS:
M. M. Fall, E. H. M. Niang, C. D. Niang, B. Niang, A. K. Toure, B. Diatta
KEYWORDS:
Chemical Burns, Sulfuric Acid, Adapted Strategy, Senegal
JOURNAL NAME:
Open Journal of Emergency Medicine,
Vol.4 No.3,
August
12,
2016
ABSTRACT: Managing severe burns remains problematic due to the lack of specialized units, but
also because of the delay in implementing emergency care. The aim is to show that an
adapted strategy, can lead to satisfying management of chemical burns. The authors
report retrospectively the case of a patient admitted for chemical burns, and treated
in a non-specialized intensive care unit; a 38 years old male, referred for burns by
sulfuric acid at his workplace. On admission to H15, the clinic did not reveal any vital
organs failure. Burns were localized on two legs and soles of the two feet (18%
TBSA). Treatment combined daily dressings with silver sulfadiazine. On day 14, the
wound healing associated occlusive gauze dressing, iodine cream application, and
mechanical debridement. On day 47, a 5% dermal autograft performed on right foot
favored with good attachment grafts. On day 58, the patient was released after complete
skin recovery. Then, in a non-specialized burn unit and without early surgery
access, our wound healing adapted strategy was successful. In Senegal, chemical
burns represent about 2.5% of burn cases. They are often from accidents on occupation
job, while generally in Africa chemical burns result from criminal attacks. Patients
with severe lesions are admitted in non-specialized environments after an extended
time of transfer, and don’t have efficient initial care. This may explain the
high morbidity and mortality after burns in our country. The lack of surgical facilities
such as skin substitutes, in non-specialized unit on low or median income countries
(LMICs), explains this long period of wound healing. The treatment of severe burn in
LMICs is hazardous.