as burn wounds. The surgeon should allow the wounds to be definitely necrotic
and non-salvageable.
VIIi. Chemical burns
Children usually suffer chemical burn injuries when coming into contact
with strong acids or alkalis such as household solvents. Alkaline agents cause
liquefactive necrosis making them more harmful that acids due to deeper tissue
penetration. Initial management consists of copious irrigation with water, for
approximately 20 minutes, to dilute the agent. Certain agents containing
calcium oxide (lime) should be dusted off the patient prior to irrigating with
water to prevent further damage caused by the resultant calcium hydroxide.
Chemical burns tend to appear superficial immediately after the injury,
however, are more likely to be deep partial or full thickness injuries.
A highly corrosive agent with a specific antidote is hydrofluoric acid. It
causes tissue destruction by the combination of its fluoride ions with calcium
and magnesium inhibiting cellular metabolism. Treatment consists of
application of calcium gluconate gel to the affected area, direct injection of
calcium gluconate to the burn or-intra-arterial infusion of calcium ions into
vessels perfusing the injured area. Pain cessation is a good indicator of
successful treatment. Patients with extensive damage caused by hydrofluoric
acid should be closely monitored in the ICU given the potential of severe