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1.
Rev. argent. cir. plást ; 27(2): 96-99, 20210000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1357912

ABSTRACT

Las quemaduras químicas en cuero cabelludo, que se producen en lugares públicos como salones de belleza o peluquerías causadas por mezclas de sustancias activas como persulfatos y peróxido de hidrógeno, secundarias a la decoloración de cabellos, producen graves secuelas de alopecias en pacientes jóvenes. Se trata de un caso clínico, de quemadura química, espesor completo, extensa, en cuero cabelludo. Productos utilizados en forma cotidiana en salones de belleza, peluquerías o domicilios, que tiene estrecha relación con el daño. Resolución del caso con colgajos locales, con tiempos de internación y quirúrgicos cortos, en tiempos de COVID. Enfoque de la falta de control de sustancias usadas en peluquerías, pocos casos publicados y secuelas psicosociales importantes, con pronta mejoría de calidad de vida y reinserción social


Chemical burns in scalp after hair bleaching are produced in public places such as hairdressing salons and are caused by the combination of active agents like persulfate and hydrogen peroxide. The burns leave severe sequels of alopecia in young patients. This is about a clinical case of a chemical burn in the sculp which is full thickness and has a great large. Products used on a daily basis in hairdressing salons or in the domiciles have a close connection with the hurt. In times of COVID the case was resolved with local flaps, and short period of hospitalization and surgical. Focus on the lack of control in the usage of substances made by hairdressing salons, the existence of few published cases and the main psychosocial sequels, a speedy recovery in the quality of life and social reintegration


Subject(s)
Humans , Adult , Quality Control , Scalp/anatomy & histology , Scalp/injuries , Surgery, Plastic/methods , Burns, Chemical/therapy , Tissue Expansion , Skin Transplantation/rehabilitation , Permissible Limits/prevention & control , Hydrogen Peroxide/toxicity
2.
Acta toxicol. argent ; 29(1): 8-10, abr. 2021. graf
Article in Spanish | LILACS | ID: biblio-1360066

ABSTRACT

Resumen Se describe un caso de quemadura causada por cloroformiato de etilo en ocasión de la respuesta a un incidente que requirió el trasvase del producto desde contenedores defectuosos a otros seguros. La investigación del evento puso en evidenciala necesidad de mantener un protocolo de registro de materiales que ingresan a la zona caliente, que debe ser tenido en cuentaal momento del retiro de los mismos, procediendo a su correcta descontaminación bajo la fiscalización del oficial de seguridad.


Abstract A burn by Ethyl chloroformate in occasion of response to a chemical emergency which required to transfer products from defective containers to safe containers is described. The investigation of the event highlighted the need to maintain aprotocol for the registration of materials to be entered in the hot zone, which must be considered al the moment of remove andproceeding to the proper decontamination under the supervision of the security officer.


Subject(s)
Humans , Burns, Chemical/prevention & control , Occupational Health
3.
Rev. chil. pediatr ; 91(2): 289-299, abr. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1098904

ABSTRACT

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.


Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) separate papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.


Subject(s)
Humans , Burns, Chemical/etiology , Caustics/toxicity , Esophagitis/chemically induced , Esophagus/injuries , Spain , Burns, Chemical/diagnosis , Burns, Chemical/physiopathology , Burns, Chemical/therapy , Esophagitis/diagnosis , Esophagitis/physiopathology , Esophagitis/therapy , Esophagus/physiopathology , Clinical Decision-Making/methods , Latin America
4.
Rev. chil. pediatr ; 91(1): 149-157, feb. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1092801

ABSTRACT

Resumen: La ingestión de cáusticos representa un grave problema médico-social por las consecuencias devastadoras e irreversibles que puede producir en el tracto digestivo superior. En Iberoamérica no se han publicado datos fidedignos sobre la incidencia o la prevalencia de lesiones inducidas por cáusticos. La información disponible sobre la presentación clínica, diagnóstico, tratamiento y pronóstico se basa en series retrospectivas de casos y, de hecho, su manejo clínico se sustenta en muchos casos fundamentalmente en la opinión de expertos. Recientemente como una iniciativa de la Sociedad Latinoamericana de Gastroenterología, Hepatología y Nutrición Pediátrica (SLAGHNP) y con la co laboración de colegas de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediá trica (SEGHNP), hemos diseñado una Guía de Práctica Clínica (GPC) la cual incluye una serie de enunciados y recomendaciones dirigidos a optimizar la atención a los pacientes y que se basan en la revisión sistemática de la evidencia. En dos (2) manuscritos sucesivos nos hemos enfocado primero, en los aspectos fisiopatológicos y de diagnóstico clínico-endoscópico de la esofagitis cáustica en niños (1a. Parte) y en segundo lugar, en los aspectos más relevantes del tratamiento (2a. Parte). Esperamos esta guía se convierta en una herramienta útil para el clínico en el difícil proceso de toma de decisio nes a la hora de evaluar un paciente posterior a la ingesta de una sustancia cáustica.


Abstract: Caustic ingestion represents a serious social-medical problem due to the devastating and irreversible consequences it can produce in the upper digestive tract. In Ibero-America, there are no published reliable data on the incidence or prevalence of caustic-induced injuries, and most of the available information on clinical presentation, diagnosis, treatment, and prognosis is based on retrospective clinical series and, indeed, its clinical management is often based primarily on expert opinion. Re cently as an initiative of the Latin American Society for Pediatric Gastroenterology, Hepatology and Nutrition (LASPGHAN) and with the cooperation of the Spanish Society for Pediatric Gastroente rology, Hepatology and Nutrition (SEGHNP), we have designed a Clinical Practice Guideline that include a series of statements and recommendations aimed at optimizing patient medical care which is based on the systematic review of evidence. Two (2) successive papers focused on the evaluation of physiopathological and clinical-endoscopic diagnostic features of caustic esophagitis in children (1st. Paper) and, on the other hand, the most relevant therapeutic considerations (2nd. Paper). We expect this guideline to become a useful tool for the physician in the difficult decision-making process when assessing patients after caustic ingestion.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Burns, Chemical/diagnosis , Burns, Chemical/etiology , Burns, Chemical/physiopathology , Burns, Chemical/therapy , Caustics/toxicity , Esophagitis/diagnosis , Esophagitis/etiology , Esophagitis/physiopathology , Esophagitis/therapy , Pediatrics
6.
Article in English | WPRIM | ID: wpr-762805

ABSTRACT

Full-thickness scalp burns secondary to hair coloring are rare; however, such defects can be large and complex reconstruction of hair-bearing tissue may be necessary. Many skin-stretching devices that use gradual traction have been applied to take advantage of the viscoelastic properties of the skin. A 21-year-old female patient was seen with a burn defect on her occipital scalp leading to exposed subcutaneous tissue after chemical application of hair coloring in a salon. The dimensions of the wound were 10 cm×5 cm, and a skin graft or flap would have been necessary to close the defect. Two long transfixing K-wires (1.4 mm) and paired 3-wire threads (23 gauge), which are readily available in most hospitals, were applied over a period of 12 days for trichophytic closure of the defect. The remaining scalp scars after primary trichophytic closure with this skin-stretching method were refined with hair follicle transplantation. This skin-stretching method is simple to apply and valuable for helping to close problematic areas of skin shortage that would otherwise require more complicated procedures. This case shows a relatively unknown complication of hair coloring and its treatment.


Subject(s)
Burns , Burns, Chemical , Cicatrix , Female , Hair Color , Hair Follicle , Hair , Humans , Methods , Scalp , Skin , Subcutaneous Tissue , Traction , Transplantation , Transplants , Wound Healing , Wounds and Injuries , Young Adult
8.
Article in English | WPRIM | ID: wpr-739376

ABSTRACT

The burn center in our hospital is a national and regional (Southeast Asia) center. Of all admissions, 10% are related to blast explosions, and 8% due to chemical burns. In the acute burn management protocol of Singapore General Hospital, early surgical debridement is advocated for all acute partial-thickness burns. The aim of early surgical debridement is to remove all debris and unhealthy tissue, preventing wound infection and thereby expediting wound healing. In chemical burns, there can be stubborn eschars that are resistant to traditional debridement. We would like to present a novel technique using the diathermy scratch pad as a cheap and efficient tool for the dual purpose of surgical debridement and dermabrasion.


Subject(s)
Burn Units , Burns , Burns, Chemical , Debridement , Dermabrasion , Diathermy , Explosions , Foreign Bodies , Hospitals, General , Singapore , Wound Healing , Wound Infection
9.
Arch. argent. pediatr ; 116(6): 409-414, dic. 2018. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-973685

ABSTRACT

Antecedentes. La ingesta de sustancias cáusticas en pediatría constituye una causa frecuente de atención médica en Urgencias. El uso indiscriminado de limpiadores químicos y la facilidad de adquisición son factores determinantes para estas lesiones. Población y métodos. Estudio descriptivo analítico. Se incluyeron niños < 16 años, entre enero de 1998 y diciembre de 2017. Se identificó el agente químico cáustico ingerido por el niño como ácido o alcalino. Se realizó una endoscopía digestiva para tipificar el grado de quemadura. Se comparó el grado de quemadura con el tipo de cáustico; por medio de la prueba de chi² o exacta de Fisher, se consideró significativo el valor de P < 0,05. Resultados. Ingresaron 133 niños en Urgencias por ingesta de cáusticos. El agente cáustico fue ácido en el 41 % y alcalino en el 59 %. El agente ácido más frecuente fue el ácido muriático (36,8 %), mientras que el alcalino fue la sosa (soda) cáustica (41,4 %). La quemadura del esófago fue más frecuente en la ingesta de sosa en comparación con otros cáusticos (p= 0,001), mientras que la quemadura del estómago (p= 0,001) y del duodeno (p= 0,002) fue estadísticamente significativa en la ingesta de ácido muriático. El grupo de edad que más frecuentemente ingirió algún cáustico (93,2 %) fueron los menores de 5 años. Conclusiones. El cáustico ingerido con mayor frecuencia fue un agente alcalino, que provocó quemadura esofágica, mientras que un agente ácido provocó quemaduras en el estómago y el duodeno evidenciadas por endoscopía.


Background. Caustic ingestion in pediatrics is a common cause of visits to the Emergency Department. An indiscriminate use of cleaning chemicals and an easy access to them are determining factors for these injuries. Population and methods. Descriptive, analytical study. Children aged < 16 years hospitalized between January 1998 and December 2017 were included. The ingested caustic substance was identified as acid or alkaline. A gastrointestinal endoscopy was done to establish the burn grade. The grade of the burn was compared to the type of caustic substance using the χ² test or the Fisher's exact test; a P value < 0.05 was considered significant. Results. A total of 133 children were admitted to the Emergency Department due to caustic ingestion. The caustic agent was acid in 41 % of cases and alkaline, in 59 %. The most common acid caustic substance was muriatic acid (36.8 %) and the most common alkaline caustic agent was caustic soda (41.4 %). An esophageal burn was the most common consequence of caustic soda ingestion compared to other caustic agents (p = 0.001), whereas muriatic acid ingestion was the most statistically significant cause of stomach burn (p = 0.001) and duodenal burn (p = 0.002). The age group that most commonly ingested some caustic agent (93.2 %) corresponded to children younger than 5 years. Conclusions. The most common type of ingested caustic agent was alkaline, which caused esophageal burn; whereas, the ingestion of an acid caustic substance caused stomach and duodenal burns, as evidenced by endoscopy.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Burns, Chemical/diagnosis , Caustics/poisoning , Endoscopy, Gastrointestinal/methods , Gastrointestinal Tract/injuries , Stomach/injuries , Acids/poisoning , Burns, Chemical/etiology , Burns, Chemical/epidemiology , Epidemiology, Descriptive , Age Factors , Duodenum/injuries , Alkalies/poisoning , Emergency Service, Hospital , Esophagus/injuries
10.
Pesqui. vet. bras ; 38(11): 2088-2091, Nov. 2018. ilus
Article in English | LILACS, VETINDEX | ID: biblio-976391

ABSTRACT

An outbreak of skin burn and ocular damage by calcium oxide in swines is reported. The outbreak occurred in a rural property located in the municipality of Iuiu, Western Bahia, during the transport of 60 pigs from a recreation farm to a fattening farm. The observed macroscopic lesions were erythematous areas; formation of papules, vesicles, and in some cases, there was the formation of firm, parched, high brown plaques and in other cases detachment and loss of skin. His eyes were dull. Histological analysis of the skin revealed areas of necrosis of focally extensive clotting of the epidermis, and dermis, delimited in the paniculus, by cellular debris and rare neutrophils. Corneal necrosis with perforated ulcer formation, superficial epithelial necrosis, edema, and neutrophil infiltration of the cornea adjacent to the ulcer were revealed in the eye.(AU)


Descreve-se um surto de queimadura de pele e lesão ocular por óxido de cálcio (cal virgem) em suínos. O surto ocorreu em uma propriedade rural localizada no município de Iuiu, região Oeste da Bahia, durante o transporte de 60 suínos de uma granja de recria para uma granja de engorda. Macroscopicamente foi evidenciado que na pele dos suínos havia áreas eritematosas, formação de pápulas, vesículas, e em alguns casos havia a formação de placas elevadas marrom firmes, ressequidas e em outros casos desprendimento e perda da pele. Os olhos estavam opacos. Na microscopia da pele observaram-se áreas de necrose de coagulação focalmente extensa da epiderme, e derme, delimitadas no panículo, por restos celulares e raros neutrófilos. No olho observou-se necrose da córnea com formação de úlcera perfurada, necrose do epitélio superficial, edema e infiltração de neutrófilos na córnea adjacente a úlcera.(AU)


Subject(s)
Animals , Swine/injuries , Burns, Chemical/veterinary , Eye Burns/chemically induced , Eye Burns/veterinary , Calcium Oxide
11.
Arq. bras. oftalmol ; 81(3): 226-231, May-June 2018. tab, graf
Article in English | LILACS | ID: biblio-950449

ABSTRACT

ABSTRACT Purpose: Nitrogen mustard (NM) is a devastating casualty agent in chemical warfare. There is no effective antidote to treat NM-induced ocular injury. We aimed to assess the effects of proanthocyanidin (PAC) and coenzyme Q10 (CoQ10) on NM-induced ocular injury. Methods: Eighteen male rats were divided into the following 4 groups: NM, NM + PAC, NM + CoQ10, and control. The 3 NM groups received a single dose of NM (0.02 mg/μL) on the right eye to induce ocular injury. The control group received saline only. Thirty minutes after the application of NM, the NM + PAC group received PAC (100 mg/kg) via gastric gavage, while the NM + CoQ10 group received CoQ10 (10 mg/kg) via intraperitoneal injection. PAC and CoQ10 were administered once a day for 5 consecutive days. The rats were then sacrificed. Macroscopic images of the eyes were examined and eye tissues were collected for histology. Results: The treatment groups were compared to the control group with regard to both corneal opacity and lid injury scores. The findings were not significantly different for both the NM + PAC and NM + CoQ10 groups. In both the NM + PAC and NM + CoQ10 groups, the histological changes seen in the NM group demonstrated improvement. Conclusions: Our results indicate that PAC and CoQ10 treatments have therapeutic effects on NM-induced ocular injury in a rat model. PAC and CoQ10 may be novel options in patients with NM-induced ocular injury.


RESUMO Objetivo: A mostarda de nitrogênio (MN) é um agente de guerra química devastador. Não existe um antídoto eficaz para tratar lesões oculares induzidas por MN. Nosso objetivo foi avaliar os efeitos da proantocianidina (PAC) e da coenzima Q10 (CoQ10) na lesão ocular induzida por MN. Métodos: Dezoito ratos machos foram divididos em 4 grupos: MN, MN + PAC, MN + CoQ10 e Controle. Três grupos receberam uma dose única de MN (0,02 mg/μL) destilada no olho direito para gerar lesão ocular. Os animais do grupo controle receberam apenas solução salina. Trinta minutos após a aplicação de MN nos animais, o grupo MN + PAC recebeu PAC (100 mg/kg) por gavagem gástrica, enquanto a CoQ10 (10 mg/kg) foi administrada ao grupo MN + CoQ10 por meio de injeção intraperitoneal. A administração de PAC e de CoQ10 foi realizada uma vez por dia, durante 5 dias consecutivos. Os ratos foram, então, sacrificados. Imagens macroscópicas dos olhos foram examinadas e tecidos oculares foram coletados para histologia. Resultados: Os grupos de tratamento foram comparados ao grupo de controle quanto à opacidade da córnea e quanto aos escores de lesão da cobertura da córnea. Os resultados foram insignificantes para ambos os grupos. Ambos, o grupo MN+PAC e o grupo MN+CoQ10, apresentaram melhoras das alterações histológicas observadas no grupo MN. Conclusões: Nossos resultados indicam que os tratamentos com PAC e com CoQ10 têm efeitos terapêuticos sobre lesões oculares induzidas por MN em um modelo em ratos. A proantocianidina e a CoQ10 podem ser uma nova opção nesses casos.


Subject(s)
Animals , Male , Rats , Burns, Chemical/drug therapy , Eye Injuries/drug therapy , Ubiquinone/analogs & derivatives , Proanthocyanidins/therapeutic use , Antioxidants/therapeutic use , Random Allocation , Chemical Warfare Agents , Eye Injuries/chemically induced , Ubiquinone/therapeutic use , Rats, Sprague-Dawley , Disease Models, Animal , Mechlorethamine
12.
ABCD arq. bras. cir. dig ; 31(2): e1381, 2018. graf
Article in English | LILACS | ID: biblio-949234

ABSTRACT

ABSTRACT Background : Complete esophago-gastric necrosis after caustic ingestion is a challenging surgical scenario for reconstruction of the upper digestive transit. Aim : To present a surgical technique for reconstruction of the upper digestive tract after total esophagectomy and gastrectomy due to esophageal and gastric necrosis Method: The transit was re-established by means of a pharyngo-ileo-colic interposition with microsurgical arterial and venous anastomosis for augmentation of blood supply. Colo-duodeno-anastomosis and ileo-transverse colic anastomosis were performed for complete digestive transit reconstruction. Result: This procedure was applied in a case of 41 years male attempted suicide by ingesting alkali caustic liquid (concentrated sodium hydroxide). Total necrosis of the esophagus and stomach occurred, which required initially total esophago-gastrectomy, closure at the level of the crico-pharyngeal sphincter and jejunostomy for enteral feeding with a highly deteriorated quality of life . The procedure was performed later and there were no major early and late postoperative complications and normal nutritional conditions were re-stablished. Conclusion: The procedure is feasible and must be managed by multidisciplinary team in order to re-establish a normal quality of life.


RESUMO Racional: A necrose esofagogástrica completa após ingestão cáustica é um cenário cirúrgico desafiador para a reconstrução do trânsito digestivo alto. Objetivo: Apresentar uma técnica cirúrgica para reconstrução do trato digestivo superior após esofagectomia total e gastrectomia por necrose esofágica e gástrica. Método: O trânsito foi restabelecido por interposição faringo-íleo-cólica com anastomose arterial e venosa microcirúrgica com aumento do suprimento sanguíneo. Adicionalmente, anastomose colo-duodeno-anastomótica e íleo-transversa foram realizadas para reconstrução completa do trânsito digestivo. Resultado: Este procedimento foi aplicado em um homem de 41 anos com tentativa de suicídio pela ingestão de líquido cáustico alcalino (hidróxido de sódio concentrado). Ocorreu necrose total do esôfago e do estômago, o que exigiu inicialmente esofagogastrectomia total, fechamento ao nível do esfíncter cricofaríngeo e jejunostomia para alimentação enteral produzindo qualidade de vida altamente deteriorada. O procedimento foi realizado mais tardiamente e não houve maiores complicações pós-operatórias precoces e tardias e condições nutricionais normais foram restabelecidas. Conclusão: O procedimento é viável e deve ser manejado por equipe multidisciplinar a fim de restabelecer a qualidade de vida normal.


Subject(s)
Humans , Male , Adult , Burns, Chemical/surgery , Caustics/toxicity , Esophagectomy , Colon/surgery , Esophagus/surgery , Esophagus/injuries , Pharynx/surgery , Stomach/surgery , Stomach/blood supply , Stomach/injuries , Stomach/pathology , Suicide, Attempted , Burns, Chemical/etiology , Anastomosis, Surgical , Esophagus/blood supply , Esophagus/pathology , Microvessels , Gastrectomy , Ileum/surgery , Necrosis
13.
Article in Korean | WPRIM | ID: wpr-766398

ABSTRACT

Caustic injury and spinal cord injury may induce pharyngeal and esophageal dysfunction, which frequently elicit dysphagia. Among the causes of dysphagia, these types of injury are related to anatomical and functional deterioration of the peripheral muscles and nerves. Various types of chemical materials cause upper aerodigestive tract burns, which induces stricture and dysphagia by scar formation. Endoscopic evaluation within 48 hours helps to predict the occurrence of stricture and dysphagia. The extent of injury or other additional complications should be assessed by plain X-ray and comupterized tomography (CT). The prevention of stricture, perforation, and dysphagia is a mainstay of treatment to reduce morbidity, and serial dilation with esophagogram and flap reconstruction should be considered in failure cases. Cervical spine injury itself causes mucosal tears or neuromuscular dysfunction, which can occur even during corrective surgery. Perforation should be evaluated by laryngoscopy, swallowing studies, plain X-ray, and CT. Both mechanical and functional obstruction that occur during the healing process can be managed by rehabilitative or surgical approaches. Dysphagia caused by chemical burns or cervical spine injury can provoke secondary complications such as aspiration pneumonia and malnutrition. Thus, adequate evaluation and management of anatomical and functional changes are required to prevent dysphagia and further complications, as well as to increase the quality of life of patients.


Subject(s)
Burns , Burns, Chemical , Cicatrix , Constriction, Pathologic , Deglutition , Deglutition Disorders , Humans , Laryngoscopy , Malnutrition , Muscles , Pneumonia, Aspiration , Quality of Life , Spinal Cord Injuries , Spine , Tears
14.
Article in Korean | WPRIM | ID: wpr-718884

ABSTRACT

FeCl₂ is often used in stainless steel surface processing, wastewater treatment, or in laboratories. Effects of exposure to FeCl₂ include predominantly systemic side effects that can occur when inhalation or oral intake occurs. However, it is known that skin irritation or burning can be caused by exposure to skin, but there has never been reported a case of deep FeCl₂ burns. We will introduce a case of a patient treated with deep second degree burn due to FeCl₂ exposure. A 27-year-old healthy man came in contact with FeCl₂ on his right wrist. The patient didn't wear any protective clothing, and the clothes were contaminated with FeCl₂ about one hour ago, but the patient was not aware of the danger of exposure. After an hour, the patient felt tingling, so he took off his exposed clothes and washed exposed skin, then came to our hospital. Initially there were mild erosion, erythema, and tingling symptoms. Two days later, eschar began to develop and wound began to deepen. Surgical procedure was not performed and it took 5 weeks for the patient's wound to heal. As a rule, workers using FeCl₂ are required to wear protective clothing. In Korea, companies and laboratories using FeCl₂ are not strictly required the use of protective clothing. Workers handling FeCl₂ should be strictly encouraged to wear protective clothing, if exposed, should be instructed to visit the hospital after a quick washing away.


Subject(s)
Adult , Burns , Burns, Chemical , Clothing , Erythema , Humans , Inhalation , Korea , Protective Clothing , Skin , Stainless Steel , Waste Water , Wounds and Injuries , Wrist
15.
Rev. méd. hondur ; 85(3/4): 124-127, jul.-dic. 2017. ilus
Article in Spanish | LILACS | ID: biblio-970340

ABSTRACT

Introducción. Las infecciones son la segunda causa de muerte materna en países de bajos ingresos. El ácido acético se conoce en la actualidad como un potente antiséptico de amplio espectro para gran positivos, gran negativos, hongos y protozoos, a través de su acción biocida y su acción biostatica, produciendo coagulación y precipitación de las proteínas, alterando las características de la permeabilidad celular y toxicidad o envenenamiento de los sistemas enzimáticos de las bacterias. Las quemaduras por ácido acético son infrecuentes y va depender para que se produzca injuria de la dilución, concentración, tiempo de exposición. Caso clínico: Se presenta el caso de una paciente de 25 años, parto por cesárea con infección y dehiscencia del sitio la herida quirúrgica tratada con antibioticos de amplio espectro, sin mejoría. Se manejó con ácido acético, provocando quemadura de segundo grado en borde de herida y pubis Discusion: El riesgo de sufrir quemaduras por ácido acético aumenta dependiendo de la tolerabilidad del paciente, el grado de concentración, dilución y el tiempo de exposición de este agente antiséptico tópico. Conclusión: Aunque las quemaduras por ácido acético son infrecuentes, siempre es necesario tener presente la dilución de la concentración adecuada y el tiempo de exposición al ácido acético, ya que dependiendo de la tolerabilidad cambia el pronóstico y tratamiento


Subject(s)
Humans , Female , Pregnancy , Adult , Burns, Chemical/complications , Acetic Acid , Anti-Infective Agents, Local/therapeutic use , Cesarean Section/methods
16.
Acta toxicol. argent ; 25(2): 47-51, set. 2017. ilus
Article in Spanish | LILACS | ID: biblio-949791

ABSTRACT

Las sustancias cáusticas son productos químicos capaces de provocar lesiones de diferente gravedad, según sea la concentración del producto, el tiempo de contacto y la vía de ingreso. La exposición es habitual por tratarse de productos utilizados en el hogar como destapacañerías y/o limpiahornos. Los cáusticos alcalinos producen necrosis por licuefacción de los tejidos. La ingesta causa edema, ulceraciones, sangrado, placas blanquecinas e intensa actividad fibroblástica con cicatrización en tres semanas. El esófago se afecta más que el estómago, en especial cuando se trata de productos sólidos o en escamas. La secuela observada es la estenosis esofágica, la cual puede requerir desde procedimientos de dilatación hasta cirugía de reemplazo, con alta morbilidad. El objetivo del trabajo es presentar tres casos clínicos y sus complicaciones a largo plazo; recordar el manejo inicial del paciente que ingiere cáusticos alcalinos, su seguimiento multidisciplinario y resaltar las medidas de prevención para evitar este tipo de accidentes graves.


Caustic are chemical substances capable of causing different degree of lesions, according to the product concentration, the time and the route of contact. The usual exposure is because of their use as household products such as drain openers and oven cleaners. Caustic alkalis produce tissue liquefaction necrosis. Ingestion causes edema, ulceration, bleeding, whitish plaques and intense fibroblastic activity with healing in three weeks. The esophagus is more affected than the stomach, especially when solids are involved. The observed sequel is esophageal stricture, requiring treatments as dilation or replacement surgery, with high morbilidad. The aim of the paper is to report three clinical cases and their long-term complications; review the initial management of patients who ingested caustic alkali, highlighting its multidisciplinary monitoring and prevention measures to avoid such serious accidents.


Subject(s)
Humans , Child, Preschool , Sodium Hydroxide/adverse effects , Sodium Hydroxide/toxicity , Burns, Chemical , Esophagus/injuries , Caustics/toxicity , Esophageal Stenosis/chemically induced
17.
Arq. bras. oftalmol ; 80(4): 252-256, July-Aug. 2017. tab, graf
Article in English | LILACS | ID: biblio-888121

ABSTRACT

ABSTRACT Purpose: To evaluate and compare the effects of topical application and subconjunctival injection of bevacizumab on corneal neovascularization (CNV) in rabbits' eyes after chemical burning of the cornea. Methods: The animals were randomly distributed into four groups of five animals. In one group, the drug was instilled, while in another, it was administered by subconjunctival injection. The two procedures using bevacizumab were compared with instillation and subconjunctival injection of saline solution (S). Neovascularization was evaluated according to the size of the invasion area of new blood vessels and through computerized analysis of this area. The data were analyzed using the Kruskal-Wallis test followed by Dunn's test for two-by-two comparison of the groups, to assess the external examination of CNV. Analysis of variance was used to assess the area of CNV. P<0.05 was considered statistically significant. Results: Assessing both the external examination and the invasion area of neovessels on the 5th and 10th days, there was a clear difference between the groups. The group to which saline solution had been applied showed higher scores for CNV, as well as increases in the invasion area of neovessels. Two-by-two comparison of groups revealed no significant differences. However, an analysis of the factors involved (injection vs. instillation and bevacizumab vs. saline solution) showed that injection did not differ from instillation, but that bevacizumab differed from saline solution. Conclusion: Bevacizumab showed an inhibitory effect on CNV in rabbits' eyes after chemical burning of the cornea. There was no difference between the topical or subconjunctival administration of bevacizumab in the inhibition of CNV.


RESUMO Objetivos: Avaliar e comparar o efeito do uso tópico e da injeção subconjuntival do bevacizumabe na neovascularização corneana de olhos de coelhos após queimadura química. Métodos: Os animais foram distribuídos de forma aleatória em quatro grupos de cinco animais. Em um grupo de coelhos a droga foi instilada, enquanto em outro foi aplicada injeção subconjuntival, sendo os dois procedimentos comparados com a instilação e injeção subconjuntival de soro fisiológico 0,9% (SF) e entre si. A neovascularização foi avaliada conforme o tamanho da área de invasão dos neovasos e com análise computadorizada da mesma. Na análise de dados aplicou-se o teste de Kruskal-Wallis seguido do teste de Dunn com p<0,05 para comparação dos grupos dois a dois na análise do exame externo da neovascularização corneana. Na análise da área de neovascularização corneana, aplicou-se o teste F de análise de variância. A significância estatística foi definida como valor de p<0.05. Resultados: A avaliação do exame externo e da área de invasão de neovasos, no 5º e 10º dia, mostrou nítida diferença entre os grupos. Com o uso de soro fisiológico houve maior graduação na escala de neovascularização corneana e também na área de invasão dos nevasos, o que demonstrou o efeito inibitório do bevacizumabe. Nas comparações dos grupos dois a dois não foram detectadas diferenças significativas, porém, ao analisar os fatores envolvidos (procedimentos: injeção ou instilação, e as drogas: bevacizumabe ou soro fisiológico), verificou-se que a injeção não diferiu da instilação, mas o bevacizumabe diferiu do soro fisiológico. Conclusão: O bevacizumabe apresentou efeito inibitório na neovascularização corneana de olhos de coelhos após queimadura química, tanto por via tópica como por via subconjuntival e não houve diferença entre a via tópica e a via subconjuntival de administração do bevacizumabe na inibição da neovascularização corneana.


Subject(s)
Animals , Male , Rats , Corneal Neovascularization/drug therapy , Cornea/drug effects , Angiogenesis Inhibitors/administration & dosage , Bevacizumab/administration & dosage , Ophthalmic Solutions , Burns, Chemical , Random Allocation , Eye Burns , Administration, Topical , Corneal Neovascularization/pathology , Cornea/innervation , Vascular Endothelial Growth Factors/antagonists & inhibitors , Disease Models, Animal , Injections, Intraocular , Corneal Injuries/chemically induced
18.
Arch. argent. pediatr ; 115(2): e85-e88, abr. 2017. tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-838343

ABSTRACT

Las lesiones esofágicas o gástricas secundarias a la ingesta de sustancias cáusticas siguen siendo un problema importante en los países en vías de desarrollo. El espectro clínico puede variar desde la ausencia de una lesión en la mucosa hasta complicaciones tales como quemaduras graves, estenosis y perforación. El examen físico y la evaluación endoscópica inicial son sumamente importantes para el diagnóstico. El objetivo de este estudio es presentar los casos de 154 niños sometidos a una endoscopía digestiva alta debido a la ingesta de sustancias cáusticas, entre otras, desincrustante químico, desengrasante, lavandina no rotulada, limpiador de tuberías de desagüe, limpiador de superficies, abrillantador de vajilla y ácido clorhídrico. Se observaron signos orofaríngeos positivos en 69 niños. Con la endoscopía inicial, se hallaron quemaduras en 63 niños; en 40, las quemaduras eran graves. Durante el seguimiento, se produjo estenosis en 20 niños, que fueron incluidos en el programa de dilatación. Entre ellos, fue posible dilatar e inyectar corticoides intralesionales satisfactoriamente a 14 niños. Sin embargo, tres niños fueron sometidos a una interposición de colon, y otros tres, a una gastroduodenostomía y gastroyeyunostomía.


Esophageal or gastric injuries secondary to caustic substance ingestion is still an important issue in developing countries. Its clinical spectrum can vary from absence of mucosal injury to complications such as severe burns, strictures and perforation. Physical examination and first endoscopic evaluation are very important in the diagnosis. The objective of this study is to present 154 children who were undergone upper gastrointestinal endoscopy because of caustic substance ingestion including descaler, degreaser, unlabeled bleach, drain opener, surface cleaner, dishwasher rinse aid, hydrochloric acid. Sixty-nine children had positive oropharyngeal findings. Sixty-three children were found to have burns in the first endoscopic examination and forty of these burns were severe burn. In the follow-up, twenty children developed strictures that were undergone dilatation program. Fourteen children in the dilatation program had successful dilatation and intralesional steroid injection. However three children had undergone colonic interposition and three undergone laparoscopic gastroduodenostomy and gastrojejunostomy.


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Burns, Chemical/etiology , Caustics/toxicity , Esophagus/injuries , Burns, Chemical/prevention & control , Injury Severity Score , Retrospective Studies
19.
Rev. bras. cir. plást ; 32(2): 241-244, 2017. ilus
Article in English, Portuguese | LILACS | ID: biblio-847375

ABSTRACT

Introdução: São apresentados dois casos de retração em região axilar após queimadura em que a correção cirúrgica foi realizada empregando-se zetaplastias múltiplas. Apresentamos uma tática de marcação que visa facilitar o aprendizado desse procedimento pelos residentes de Cirurgia Plástica. Métodos: Dois pacientes com retrações axilares e de membros superiores após queimadura com líquido aquecido foram submetidos à correção cirúrgica empregando-se a zetaplastia múltipla. A tática de planejamento proposta nesse estudo preconiza primeiro a marcação do retalho triangular localizado no ponto médio da retração axilar, o qual irá avançar e cruzar o eixo da cicatriz, e a partir daí o desenho dos retalhos subsequentes com ângulo de 60° entre si. Acreditamos que essa sistematização da marcação facilita o planejamento e aprendizado da plástica em Z. Resultados: Os pacientes apresentaram adequadas amplitude de movimento e recuperação funcional do membro acometido no pós-operatório. Não houve necrose das extremidades dos retalhos, que preconizamos serem cuidadosamente trabalhadas e um pouco arredondadas; e a execução do procedimento foi simples devido à tática de marcação que aplicamos. Conclusão: A tática de marcação que apresentamos é reprodutível e de fácil aprendizado. A zetaplastia múltipla foi eficaz em restabelecer a amplitude de movimento das áreas com sequela de queimadura tratadas com esse método.


Introduction: Herein, we present two cases of post-burn retraction of the axillary region, which were subsequently surgically corrected using multiple Z-plasties. We present a marking strategy to facilitate the learning of this procedure by plastic surgery residents. Methods: Two patients with axillary and upper limb retractions due to burns with hot liquids were surgically treated using multiple Z-plasties. The strategy proposed in this study recommends the marking of the triangular flap located at the midpoint of the axillary retraction, which then advances and crosses the axis of the scar. Then, subsequent flaps are made at an angle of 60° to each other. We believe that this systematization of marking facilitates the planning and learning of Z-plasty. Results: The study patients achieved an adequate range of motion and functional recovery of the affected limb postoperatively. We observed no cases of necrosis of the flap ends, which should be carefully worked and slightly rounded. The execution of the procedure was simple using the suggested marking strategy. Conclusion: The presented marking strategy was reproducible and easy to learn. Multiple Z-plasties were effective in restoring the range of motion of the areas affected by burns that were treated using this method.


Subject(s)
Humans , Male , Female , Adult , History, 21st Century , Axilla , Surgical Procedures, Operative , Surgery, Plastic , Surgical Flaps , Teaching , Burns, Chemical , Cicatrix , Contracture , Axilla/surgery , Axilla/injuries , Surgical Procedures, Operative/methods , Surgical Procedures, Operative/rehabilitation , Surgery, Plastic/rehabilitation , Surgical Flaps/surgery , Teaching/education , Burns, Chemical/surgery , Burns, Chemical/therapy , Cicatrix/surgery , Cicatrix/rehabilitation , Contracture/surgery , Contracture/therapy
20.
Article in English | WPRIM | ID: wpr-167673

ABSTRACT

We present an interesting case of arbitrary chemical burn resulting from exposure to an undiluted detergent solution as a folk remedy. A 59-year-old woman came to the emergency department presenting chemical burn on her hand. She was affected by housewife's eczema on her left hand and wanted to cure the lesion. So three days before she came to hospital, she had put her hand into an undiluted detergent solution for an hour as a folk remedy for eczema. The patient was treated with foam dressing while the wound was demarcated. After three weeks, she underwent full-thickness skin graft on her 4(th) finger only. On postoperative day 14, the grafted skin was well-taken and on postoperative day 32, the wound was healed completely with a nail growth. Dish detergent solution has been widely used in kitchen but there is no documented report of chemical burn resulting from a detergent solution. When this patient came to our hospital at first time, the wound was so inflammatory and partial necrosis was combined. So we waited for demarcation preparing even for amputation. But with application of appropriate foam dressing, the patient was healed well and required only partial skin graft. We may encounter the patients suffer from the chemical burns due to usual detergent sometimes. But we do not need to perform surgical treatment immediately. Instead, appropriate dressing will be helpful to minimize operation range.


Subject(s)
Amputation , Bandages , Burns , Burns, Chemical , Detergents , Eczema , Emergency Service, Hospital , Female , Fingers , Hand , Humans , Medicine, Traditional , Middle Aged , Necrosis , Skin , Transplants , Wounds and Injuries
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