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2.
Rev. Rol enferm ; 43(1,supl): 129-138, ene. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-193172

RESUMO

It is estimated that over 60,000 different chemicals might be used in industry, agriculture and the home environment. Chemical burns account for only 3% of the total, yet account for approximately 30% of burn deaths. The aim of the study was to identify the latest evidence on treatment of skin burns caused by chemical agents.A scope review was chosen, and articles published between 2013 and 2019 were selected. The research was conducted with the following descriptors: chemical burn and skin burn or skin injury or burn care or treatment burn and therap. CINAHL, MEDLINE, MedicLatina and Cochrane Database were searched. The survey was conducted in January and February 2019. Eleven articles were selected, such as case studies, retrospective and prospective studies. The circumstances in which the burns occurred were workplace accidents, home accidents and personal attacks. The chemical agents used were acid and base type. The burned body area was between 30% and 0.5%. The most severe outcome was three deaths. The first-line treatment approach to the lesion was prolonged lavage or H2O. Continuity of treatment integrates systemic, topical pharmacological measures, pain control, surgical and non-pharmacological therapies.The etiology of skin burns by chemist is multiple. The treatment integrates particularities that distinguish it from other burn types, and an appropriate approach has significant results in survival and recovery of the person with chemical burn


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Assuntos
Humanos , Queimaduras Químicas/enfermagem , Técnicas de Fechamento de Ferimentos/enfermagem , Infecção dos Ferimentos/prevenção & controle , Queimaduras Químicas/etiologia , Cicatrização , Anti-Infecciosos Locais/uso terapêutico
3.
Toxicol Lett ; 320: 73-79, 2020 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-31811912

RESUMO

INTRODUCTION: Choking agent exposure, among them chlorine gas, occurs in household or industrial accidents, chemical warfare and terrorist attacks. AIMS: Review of published animal and human data regarding the history, pathophysiology, clinical effects and management of chlorine exposure. PATHOPHYSIOLOGY: Highly soluble agents cause quick upper respiratory tract symptoms. Chlorine gas has a medium solubility, also causing delayed lower airway symptoms, mainly due to its oxidizing potential by releasing hypochlorous and hydrochloric acid, but also by interacting with Transient Receptor Potential channels. SYMPTOMS: Eyes may show conjunctival injection, abrasions and corrosions. Burns of the oronasal mucosa and trachea can occur. Dyspnea, bronchospasm and possible retrosternal pain occur frequently. Glottis edema or laryngospasm are acute life-threatening emergencies. Chlorine gas can cause toxic pneumonitis, lung edema and acute respiratory distress syndrome (ARDS). MANAGEMENT: General management includes physical examination, pulse oximetry and arterial blood gases. Eyes should be irrigated, humidified oxygen and inhalative bronchodilators administered. An EKG, cardiac enzymes and complete-blood-count should be obtained if there is retrosternal pain. Routine chest x-ray is not recommended - except if pulmonary edema is suspected. Laryngoscopy should be performed if glottis edema is suspected. Sodium bicarbonate inhalation after chlorine gas inhalation is discussed controversially. Mechanical ventilation with continuous-positive-airway-pressure or intubation/tracheotomy with high positive-end-expiratory-pressure may be necessary. Glucocorticoids for prevention of pulmonary edema should be applied restrictively. Prophylactic antibiotics are not recommended. In severe ARDS, extracorporeal membrane oxygenation (ECMO) can be considered. CONCLUSION: Treatment is mainly symptom oriented. New and promising therapies are in development.


Assuntos
Acidentes Domésticos , Acidentes de Trabalho , Queimaduras Químicas/terapia , Substâncias para a Guerra Química/envenenamento , Cloro/envenenamento , Queimaduras Oculares/terapia , Doenças Respiratórias/terapia , Animais , Queimaduras Químicas/etiologia , Queimaduras Químicas/história , Queimaduras Químicas/fisiopatologia , Substâncias para a Guerra Química/história , Cloro/história , Queimaduras Oculares/induzido quimicamente , Queimaduras Oculares/história , Queimaduras Oculares/fisiopatologia , História do Século XX , História do Século XXI , Humanos , Exposição por Inalação/efeitos adversos , Exposição Ocupacional/efeitos adversos , Prognóstico , Doenças Respiratórias/induzido quimicamente , Doenças Respiratórias/história , Doenças Respiratórias/fisiopatologia , Medição de Risco
4.
Anesth Analg ; 130(3): 665-672, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-30829672

RESUMO

Button battery ingestions result in significant morbidity and mortality in children-before, during, and even after removal. The injuries created by a button battery lodged in the esophagus develop rapidly and can be severe. The current of the button battery, conducted through saliva and the tissue drives a highly alkaline caustic injury, leading to liquefactive tissue necrosis. In June 2018, new guidelines were released from the National Capital Poison Center, which include the use of preoperative protective, pH-neutralizing and viscous barrier interventions with honey and/or sucralfate administered within 12 h of ingestion. In addition, the use of postremoval irrigation of the esophagus with 50-150 mL 0.25% acetic acid is done in the operating room to help neutralize the site of tissue injury. Given that anesthesiologists play an important role in the management of esophageal foreign body removal, the entire specialty needs to be aware of the supporting data behind this and general perioperative considerations for management and potential complications of button battery ingestion.


Assuntos
Anestesiologia/normas , Queimaduras Químicas/terapia , Fontes de Energia Elétrica , Esôfago/lesões , Corpos Estranhos/terapia , Guias de Prática Clínica como Assunto/normas , Ácido Acético/administração & dosagem , Adolescente , Fatores Etários , Queimaduras Químicas/etiologia , Queimaduras Químicas/patologia , Criança , Pré-Escolar , Consenso , Procedimentos Clínicos , Técnicas de Apoio para a Decisão , Esôfago/patologia , Corpos Estranhos/complicações , Corpos Estranhos/patologia , Mel , Humanos , Lactente , Necrose , Fatores de Risco , Sucralfato/administração & dosagem , Irrigação Terapêutica , Resultado do Tratamento
5.
Cornea ; 38(12): 1589-1594, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31453878

RESUMO

PURPOSE: To review clinical aspects and cellular and molecular steps in the development of long-term glaucoma after corneal surgery or acute trauma-especially the pivotal role of tumor necrosis factor alpha (TNF-α), the rapidity of the secondary damage to the retinal ganglion cells, and the clinical promise of early antiinflammatory intervention. METHODS: A series of laboratory studies on post-injury and post-surgery glaucoma have been compared to clinical outcome studies on the subject, focusing particularly on the vulnerability of the retinal ganglion cells. Alkali burn to the cornea of mice and rabbits served as the main experimental model. TNF-α titer, ganglion cell apoptosis, and depletion of optic nerve axons have been examined. Anti-TNF-α antibodies or corticosteroids have been used to protect the retinal ganglion cells. Intraocular pressure (IOP) postburn was recorded by manometric methods. RESULTS: In animals with alkali burn to the cornea, damage to the retina can occur within 24 to 72 hours. This is not because of a direct pH change posteriorly-the alkali is effectively buffered at the iris-lens level. Rather, TNF-α (and other inflammatory cytokines), generated anteriorly, rapidly diffuses posteriorly to cause apoptosis of the ganglion cells. During this time, the IOP remains much lower than the reported values required to cause ganglion cell damage. The TNF-α antibody infliximab or corticosteroids, if administered promptly, are markedly protective of the ganglion cells. CONCLUSIONS: A rapidly initiated, inflammatory (TNF-α mediated), IOP-independent pathway to glaucoma, resulting from acute anterior segment trauma or surgery, has been identified in laboratory studies. Prompt prophylactic treatment with antiinflammatory agents has been shown to be markedly neuroprotective of retinal ganglion cells, presumably capable of reducing the risk of late glaucoma.


Assuntos
Doenças da Córnea/cirurgia , Lesões da Córnea/complicações , Glaucoma/etiologia , Pressão Intraocular/fisiologia , Procedimentos Cirúrgicos Refrativos/efeitos adversos , Fator de Necrose Tumoral alfa/metabolismo , Animais , Queimaduras Químicas/etiologia , Queimaduras Químicas/metabolismo , Doenças da Córnea/metabolismo , Lesões da Córnea/metabolismo , Queimaduras Oculares/induzido quimicamente , Queimaduras Oculares/metabolismo , Glaucoma/metabolismo , Camundongos , Coelhos , Células Ganglionares da Retina/metabolismo , Tonometria Ocular
6.
Int Wound J ; 16(6): 1330-1338, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31446674

RESUMO

There are many chemicals that can cause burns. Although they are generally acidic and basic in nature, there are more than one million known chemical compounds, of which 300 have been declared highly hazardous chemical substances by the National Fire Protection Society. Chemical burns account for approximately 10.7% of all burn injuries and 30% of deaths because of burns. Chemicals can be classified as acid, alkali, organic, and inorganic compounds. Acids act by denaturing and coagulating proteins. Alkaline burns cause deeper burns than acid burns.


Assuntos
Queimaduras Químicas/etiologia , Ácido Acético/toxicidade , Acetona/toxicidade , Air Bags/efeitos adversos , Queimaduras Químicas/patologia , Cáusticos/toxicidade , Cianoacrilatos/toxicidade , Humanos , Hidrocarbonetos/toxicidade , Hidroquinonas/toxicidade , Hidróxido de Sódio/toxicidade
7.
Emerg Nurse ; 27(4): 17-19, 2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31468846

RESUMO

This article describes the case of a 33-year-old man with cerebral palsy who sustained a full-thickness burn to his thorax as a result of lying in gastric acid that had leaked from a damaged percutaneous endoscopic gastrostomy feeding tube. The patient required referral to a tertiary burns centre for specialist management. The article highlights the potential harm caused by gastric acid and why some patients may be particularly vulnerable to such injuries.


Assuntos
Queimaduras Químicas/etiologia , Gastrostomia/efeitos adversos , Traumatismos Torácicos/induzido quimicamente , Adulto , Queimaduras Químicas/terapia , Paralisia Cerebral , Falha de Equipamento , Humanos , Masculino , Traumatismos Torácicos/terapia
8.
Cutis ; 103(6): 346-350, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31348449

RESUMO

Chemical burns to the eyes are one of the few ocular emergencies that dermatologists may encounter in their everyday clinic. As such, dermatologists should be confident in their ability to urgently manage ocular chemical injuries should accidental exposure occur during a procedure. We report a case of accidental ocular exposure to aluminum chloride hexahydrate during skin biopsy of the cheek and subsequent transient ocular injury that resolved with early appropriate management. This article provides background information on acute chemical ocular injuries, offers practical step-by-step guidance for the dermatologist, and highlights immediate copious irrigation as perhaps the most critical step in determining the clinical course of the injury.


Assuntos
Cloreto de Alumínio/efeitos adversos , Queimaduras Químicas/terapia , Queimaduras Oculares/terapia , Irrigação Terapêutica/métodos , Cloreto de Alumínio/administração & dosagem , Queimaduras Químicas/etiologia , Dermatologia/métodos , Emergências , Queimaduras Oculares/induzido quimicamente , Feminino , Humanos , Pessoa de Meia-Idade
9.
Cutis ; 103(4): 195-196, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31116815

RESUMO

Millipedes often are regarded as harmless but are capable of causing adverse reactions through the secretion of toxic chemicals. Millipede burns cause localized pigmentary changes that may be associated with pain or burning in some patients. Clinical suspicion and physical examination are paramount to the diagnosis of millipede burns.


Assuntos
Venenos de Artrópodes/toxicidade , Artrópodes , Benzoquinonas/toxicidade , Queimaduras Químicas/diagnóstico , Animais , Queimaduras Químicas/etiologia , Criança , Diagnóstico Diferencial , Pé/patologia , Humanos
11.
Laryngoscope ; 129(8): 1772-1776, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-30835848

RESUMO

OBJECTIVES/HYPOTHESIS: Pediatric esophageal button battery (BB) injuries can progress even after removal and continue to be a significant source of morbidity and mortality. The objective in this case series is to present initial safety data for the human application of intraoperative tissue pH neutralization using 0.25% acetic acid irrigation after BB removal. STUDY DESIGN: Retrospective case series. METHODS: Pediatric patients who underwent rigid esophagoscopy for BB removal between October 2016 and December 2017 and who had the injury site irrigated with 120 to 150 mL sterile 0.25% acetic acid (pH = 3) were included in the study. Outcome measures included visual tissue appearance after irrigation, immediate or delayed esophageal perforation, and evidence of eventual esophageal stricture formation. RESULTS: Six pediatric patients (aged 19 months-10 years) had a 3 V lithium BB lodged in the esophagus for 2 to 18 hours and had irrigation of the esophageal injury site with sterile 0.25% acetic acid in the operating room after BB removal. None of the patients showed any evidence of thermal tissue injury. By surgeon assessment, all cases had improved visual esophageal tissue appearance. Neither immediate post-operative or delayed onset esophageal perforation nor eventual stricture development were seen. CONCLUSIONS: Esophageal irrigation in the operating room with sterile 0.25% acetic acid after BB removal, to neutralize the highly alkaline tissue microenvironment (pH 10-13) was safe and resulted in improved visual mucosal appearance. This immediate tissue pH neutralization may help halt the progression of liquefactive necrosis by immediately bringing tissue pH to physiologic range. This post-removal irrigation technique is recommended by current National Capital Poison Center BB guidelines. LEVEL OF EVIDENCE: 4 Laryngoscope, 129:1772-1776, 2019.


Assuntos
Queimaduras Químicas/terapia , Fontes de Energia Elétrica/efeitos adversos , Esôfago/lesões , Corpos Estranhos/terapia , Irrigação Terapêutica/métodos , Queimaduras Químicas/etiologia , Criança , Pré-Escolar , Perfuração Esofágica/etiologia , Perfuração Esofágica/terapia , Estenose Esofágica/etiologia , Estenose Esofágica/terapia , Esofagoscopia , Esôfago/cirurgia , Feminino , Corpos Estranhos/complicações , Humanos , Concentração de Íons de Hidrogênio , Lactente , Lítio , Masculino , Radioisótopos , Estudos Retrospectivos , Resultado do Tratamento
13.
World J Gastroenterol ; 25(7): 870-879, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30809086

RESUMO

BACKGROUND: The caustic ingestion continues to be a major problem worldwide especially in developing countries. The long-term complications include stricture and increased life time risk of oesophageal carcinoma. Patients suffered from corrosive induced oesophageal strictures have more than a 1000-fold risk of developing carcinoma of the oesophagus. AIM: To determine the possibility of oesophageal mucosal dysplasia after prolonged dilatation in post corrosive stricture. METHODS: This observational study was conducted at the Paediatric Endoscopy Unit in Cairo University Children's Hospital. It included children of both sexes older than 2 years of age who had an established diagnosis of post-corrosive oesophageal stricture and repeated endoscopic dilatation sessions for more than 6 mo. All patients were biopsied at the stricture site after 6 mo of endoscopic dilatation. A histopathological examination of an oesophageal mucosal biopsy was performed for the detection of chronic oesophagitis, inflammatory cellular infiltration and dysplasia. RESULTS: The mean age of the enrolled children was 5.9 ± 2.6 years; 90% of the patients had ingested an alkaline corrosive substance (potash). The total number of endoscopic dilatation sessions were ranging from 16 to 100 with mean number of sessions was 37.2 ± 14.9. Histopathological examination of the specimens showed that 85% of patients had evidence of chronic oesophagitis (group A) in the form of basal cell hyperplasia, hyperkeratosis and subepithelial fibrosis. Thirteen percent of the patients had evidence of reactive atypia (group B) in the form of severe neutrophilic intraepithelial inflammatory cellular infiltration, and 2 patients (2%) had mild squamous dysplasia (group C); we rebiopsied these two patients 6 mo after the initial pathological assessment, guided by chromoendoscopy by Lugol's iodine. CONCLUSION: The histopathology of oesophageal mucosal biopsies in post-corrosive patients demonstrates evidence of chronic oesophagitis, intraepithelial inflammatory cellular infiltration and dysplasia. Dysplasia is one of the complications of post-corrosive oesophageal stricture.


Assuntos
Queimaduras Químicas/complicações , Cáusticos/toxicidade , Mucosa Esofágica/patologia , Estenose Esofágica/patologia , Esofagite/patologia , Adolescente , Biópsia , Queimaduras Químicas/etiologia , Criança , Pré-Escolar , Dilatação/métodos , Egito , Mucosa Esofágica/diagnóstico por imagem , Mucosa Esofágica/efeitos dos fármacos , Neoplasias Esofágicas/patologia , Neoplasias Esofágicas/prevenção & controle , Estenose Esofágica/induzido quimicamente , Estenose Esofágica/diagnóstico por imagem , Estenose Esofágica/cirurgia , Esofagite/induzido quimicamente , Esofagite/diagnóstico por imagem , Esofagoscopia/métodos , Feminino , Humanos , Masculino
14.
Pediatr Emerg Care ; 35(12): e234-e235, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30702643

RESUMO

We present an illustrative case of unintentional burns to the feet of a 15-month-old child following the application of raw garlic as a home remedy for fever. We provide an overview of the historical medicinal uses of garlic as well as its unintended adverse effects. This case underscores the importance of clinicians' ability to recognize unusual presentations of injury due to culturally based practices that require care in emergency settings. This is particularly important in patient populations for whom abusive etiology would be considered.


Assuntos
Queimaduras Químicas/patologia , Febre/terapia , Traumatismos do Pé/induzido quimicamente , Alho/efeitos adversos , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Bacitracina/administração & dosagem , Bacitracina/uso terapêutico , Bandagens/normas , Queimaduras Químicas/tratamento farmacológico , Queimaduras Químicas/etiologia , Feminino , Febre/complicações , Traumatismos do Pé/patologia , Humanos , Lactente , Medicina Tradicional/efeitos adversos , Fenóis/administração & dosagem , Resultado do Tratamento
15.
Invest Ophthalmol Vis Sci ; 60(1): 245-254, 2019 01 02.
Artigo em Inglês | MEDLINE | ID: mdl-30646013

RESUMO

Purpose: Pathologic corneal neovascularization is a major cause of blindness worldwide, and treatment options are currently limited. VEGF is one of the critical mediators of corneal neovascularization but current anti-VEGF therapies have produced limited results in the cornea. Thus, additional therapeutic agents are needed to enhance the antiangiogenic arsenal. Our group previously demonstrated epithelial membrane protein-2 (EMP2) involvement in pathologic angiogenesis in multiple cancer models including breast cancer and glioblastoma. In this paper, we investigate the efficacy of anti-EMP2 immunotherapy in the prevention of corneal neovascularization. Methods: An in vivo murine cornea alkali burn model was used to study pathologic neovascularization. A unilateral corneal burn was induced using NaOH, and subconjunctival injection of either anti-EMP2 antibody, control antibody, or sterile saline was performed after corneal burn. Neovascularization was clinically scored at 7 days postalkali burn, and eyes were enucleated for histologic analysis and immunostaining including VEGF, CD31, and CD34 expression. Results: Anti-EMP2 antibody, compared to control antibody or vehicle, significantly reduced neovascularization as measured by clinical score and central cornea thickness, as well as by histologic reduction of neovascularization, decreased CD34 staining, and decreased CD31 staining. Incubation of corneal limbal cells in vitro with anti-EMP2 blocking antibody significantly decreased EMP2 expression, VEGF expression and secretion, and cell migration. Conclusions: This work demonstrates the effectiveness of EMP2 as a novel target in pathologic corneal neovascularization in an animal model and supports additional investigation into EMP2 antibody blockade as a potential new therapeutic option.


Assuntos
Anticorpos Bloqueadores/uso terapêutico , Neovascularização da Córnea/terapia , Modelos Animais de Doenças , Imunoterapia , Glicoproteínas de Membrana/imunologia , Animais , Antígenos CD34/metabolismo , Western Blotting , Queimaduras Químicas/etiologia , Queimaduras Químicas/metabolismo , Queimaduras Químicas/terapia , Movimento Celular , Células Cultivadas , Neovascularização da Córnea/etiologia , Neovascularização da Córnea/metabolismo , Ensaio de Imunoadsorção Enzimática , Células Epiteliais/metabolismo , Queimaduras Oculares/induzido quimicamente , Feminino , Células Endoteliais da Veia Umbilical Humana , Humanos , Limbo da Córnea/citologia , Glicoproteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos BALB C , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Hidróxido de Sódio , Fator A de Crescimento do Endotélio Vascular/metabolismo
16.
Curr Eye Res ; 44(5): 505-513, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30595046

RESUMO

PURPOSE: To determine whether Toll-like receptor 4 knockout protects mice from corneal neovascularization following chemical injury compared to wild-type (WT) mice. METHODS: A chemical burn (75% silver nitrate, 25% potassium nitrate) was created under anesthesia in the central right cornea of 32 WT and 31 Toll-like receptor 4 knockout mice. Corneal neovascularization was evaluated at 3, 4, 6, 8, 10, and 35 days after injury using digital photography, fluorescein angiography, gelatin perfusion with fluorescence vascular imaging, immunofluorescence staining, and molecular analysis. RESULTS: There was no significant between-group difference in relative corneal burn area at 10 days after injury (39.0 ± 2.4% vs. 38.8 ± 9.8%, respectively). Neovascularization was detected in all corneas in vivo and perfusion was detected by fluorescence vascular imaging, reaching maximum area on day 10. The relative area of neovascularization was significantly smaller in the knockout than the WT mice on days 6 (33.3 ± 4.2% vs. 46.8 ± 7.4%, respectively, p = 0.005) and 8 (36.6 ± 1.1% vs. 52.2 ± 6.4%, respectively, p = 0.027), although neovascularization was intensive in both groups. In line with the immunostaining findings of angiogenesis and inflammatory infiltration of damaged corneas, molecular analysis (performed on day 3) revealed elevated expression levels of angiogenesis-related genes (vascular endothelial growth factor, VEGFR2, VEGFR1) and inflammation-related genes (CD45 and TGFß1) in the WT mice. The knockout mice had higher TNF-α expression than the WT mice. CONCLUSION: In a mouse corneal chemical burn model, lack of Toll-like receptor 4 expression did not completely inhibit angiogenesis, but did have a relative effect to reduce neovascularization as compared to the WT.


Assuntos
Queimaduras Químicas/prevenção & controle , Neovascularização da Córnea/prevenção & controle , Modelos Animais de Doenças , Queimaduras Oculares/induzido quimicamente , Regulação da Expressão Gênica/fisiologia , Receptor 4 Toll-Like/genética , Animais , Queimaduras Químicas/etiologia , Queimaduras Químicas/metabolismo , Córnea/irrigação sanguínea , Neovascularização da Córnea/etiologia , Neovascularização da Córnea/metabolismo , Combinação de Medicamentos , Angiofluoresceinografia , Técnica Indireta de Fluorescência para Anticorpo , Antígenos Comuns de Leucócito/genética , Antígenos Comuns de Leucócito/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Nitratos/toxicidade , Fotografação , Compostos de Potássio/toxicidade , Reação em Cadeia da Polimerase em Tempo Real , Nitrato de Prata/toxicidade , Fator de Crescimento Transformador beta1/genética , Fator de Crescimento Transformador beta1/metabolismo , Receptor 1 de Fatores de Crescimento do Endotélio Vascular/genética , Receptor 2 de Fatores de Crescimento do Endotélio Vascular/genética
17.
Burns ; 45(4): 763-771, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30442380

RESUMO

INTRODUCTION: Electronic cigarettes (EC) have been reported to be associated with burns secondary to explosions of the device or battery, or contact from overheating, resulting in flame, contact or chemical burns. In addition to this, there have also been reported cases of soft tissue and bony trauma with or without associated burns. Using collective evidence, this review aims to summarise all reported burns associated with ECs, and its implications on immediate management with a particular focus on surgical treatment. METHODS: A search was conducted on PubMed, EMBASE and Medline for all case reports, case series and letters to editors published since 2014, using terms "electronic cigarette", "e-cigarette", "vaping" and "burn". The search was repeated by the co-author to avoid bias and a review of the bibliographies of each paper was conducted to ensure all relevant cases were included. The mechanisms, type and severity of burn injury, and management and treatment outcomes of the patients were recorded. Exclusion criteria included non-English articles, explosions with no associated burn and publications with insufficient information. RESULTS: 90 patients from 19 case series or case reports were included. With the exception of one study, gender was recorded with a male predominance (95.6%). Mean age is 30.1years (range 18-59). The most common type of burn was flame. However, there were reports of chemical burns associated with ECs. The mean total body surface area (TBSA) affected was 4.9% (range 1-27.25%) with the majority of burns being mixed partial and full thickness. 22 patients underwent excision and autologous skin grafting within range of three to 21days. One patient had a full thickness contact burn excised and closed, one patient received a xenograft following debridement and one had biosynthetic skin dressing. 42 patients were managed conservatively with dressings or ointments. DISCUSSION: In this review over a three-year period (2015-2017), 90 cases of EC related burn injuries were reported, however, this is likely an underestimation of the problem. The suggested mechanism for EC related injuries is battery malfunction. ECs are powered by Lithium ion batteries which are susceptible to "thermal runaway" reactions, which result in device overheating with potential for subsequent explosion. We explain hypothesized triggers for these reactions and mechanisms of other injuries associated with ECs such as chemical burns and blast injury. CONCLUSION: EC-associated burn injury results in combined thermal and chemical burns, which should be managed in tandem. Explosion injuries sustained whilst using the device may result in both facial trauma or inhalation injury and therefore should be reviewed with a high index of clinical suspicion. It is noted that there is no agreed standard for management for such burns by specialist bodies in the UK. We suggested a treatment algorithm to provide guidance for the burn injuries associated with ECs.


Assuntos
Queimaduras/terapia , Fontes de Energia Elétrica/efeitos adversos , Sistemas Eletrônicos de Liberação de Nicotina , Traumatismos Faciais/terapia , Guias de Prática Clínica como Assunto , Algoritmos , Traumatismos por Explosões/etiologia , Traumatismos por Explosões/terapia , Queimaduras/etiologia , Queimaduras Químicas/etiologia , Queimaduras Químicas/terapia , Queimaduras por Inalação/etiologia , Queimaduras por Inalação/terapia , Gerenciamento Clínico , Traumatismos Faciais/etiologia , Humanos , Concentração de Íons de Hidrogênio
19.
J Burn Care Res ; 40(1): 133-135, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29931078

RESUMO

Over the years, many cultures have used herbs for serious health problems. Garlic (Allium sativum) pose hypocholesterolemic, fibrinolytic, antidiabetic, and antibiotic actions. However, it has unusual adverse effects such as chemical burns and contact dermatitis when used topically. In this case report, the authors present two cases of topical garlic burn caused after the use of crushed garlic with a bandage for pain relief due to arthritis.


Assuntos
Lesões nas Costas/induzido quimicamente , Queimaduras Químicas/etiologia , Alho/efeitos adversos , Traumatismos do Joelho/induzido quimicamente , Medicina Tradicional/efeitos adversos , Manejo da Dor/efeitos adversos , Lesões nas Costas/terapia , Queimaduras Químicas/terapia , Feminino , Humanos , Traumatismos do Joelho/terapia , Masculino , Pessoa de Meia-Idade
20.
J Burn Care Res ; 40(1): 140-142, 2019 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-29757438

RESUMO

A chemical alkali burn caused by ash and soot is quite rare, resulting from its high pH-value, and underestimated in its potential to cause injury. In folkloric medicine, ash was purportedly used to relieve pain. We present an unusual case of a 27-year-old man who used a self-mixed cream of soot of wooden pellets, milking grease and baby oil to blacken his face and hands for a traditional Krampus procession.


Assuntos
Álcalis/efeitos adversos , Queimaduras Químicas/etiologia , Traumatismos Faciais/induzido quimicamente , Traumatismos da Mão/induzido quimicamente , Hidrocarbonetos/efeitos adversos , Lesões dos Tecidos Moles/induzido quimicamente , Fuligem/efeitos adversos , Adulto , Áustria , Queimaduras Químicas/cirurgia , Traumatismos Faciais/cirurgia , Traumatismos da Mão/cirurgia , Férias e Feriados , Humanos , Masculino , Lesões dos Tecidos Moles/cirurgia
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