![]() ![]() 14 The majority of chemical burns of the eyelids are partial-thickness (first and superficial second degree) and heal spontaneously within 1 week. These attributes make sulfuric acid an effective drain cleaner, and a substantial number of accidental and intentional incidents are caused by drain cleaners. It generates significant heat when diluted and is highly hygroscopic. 12, 13 It is a corrosive, oily, colourless liquid with a specific gravity of 1.85 and a boiling point of 340☌. Sulfuric acid is one of the agents most often involved. Both acids and alkalis can cause immediate skin burns on exposure. For alkalis, sodium hydroxide and potassium hydroxide are the most common. 9- 10įor acids, sulfuric acid, hydrochloric acid and hydrofluoric acid are the most commonly seen in burns. Such burns are commonly small in size, and the most common burn areas are the face and limbs. 8 The majority of patients are of working age and acids are the most common causative agent. In developing countries, 80% of chemical burns are due to industrial exposure and 20% to physical assault. Most periorbital burns are the result of thermal injury 4 however, chemical burns are reported to comprise 1.4–8.5% of all admission cases due to burns. 2 3 Burns can be caused by heat, electricity, or chemical exposure. 1 These injuries may be associated with significant medical and psychological morbidity.2 Eye and eyelid involvement is common in facial burns, with approximately 15 to 20% of patients presenting orbital injury. L’excision-greffe précoce améliore la pronostic oculaire après brûlure par acide sulfurique Ce cas clinique illustre la nécessité d’une analyse précoce (dans les 6h) par ophtalmologiste et plasticien afin de définir une stratégie coordonnée vis à vis du globe oculaire et de la paupière. Les rapports de brûlures chimiques des paupières sont peu fréquents et il nous n’avons pas trouvé de protocole dans la littérature. Ces bons résultats persistaient à 2 mois, sans lagophtalmie ni défaut d’occlusion, avec un aspect esthétique correct. La fonction palpébrale était normale et l’occlusion oculaire complète. À J10, la greffe était totalement intégrée et le site donneur (bras droit) était cicatrisé. Nous présentons le cas d’une femme victime d’une agression intra-familiale à l’acide sulfurique, souffrant de brûlure des 2ème et 3ème degrés des paupières traitée par excision-greffe de peau totale précoce. ![]() Nous conjecturons qu’une excision-greffe précoce améliore le pronostic à long terme de ce type de brûlure. Cette stratégie comporte le risque d’une cicatrisation défectueuse source d’ectropion, d’occlusion incomplète et de kératite. There is a significant improvement in ocular healing with early excision and grafting of eyelids after sulfuric acid burnĮn cas de brûlure du 2ème ou du 3ème degré des paupières par acide sulfurique, de nombreux chirurgiens préfèrent attendre la séparation spontanée de l’escarre avant de greffer. This case report demonstrated that a multidisciplinary approach led by both ophthalmologists and plastic surgeons must be decided early (<6h) in order to achieve synergistic and coordinated management between the eye and the eyelid. No specific and codified management of eyelid chemical burns was found in the literature search. Case reports of eyelid chemical burns are very few. Two months after surgery, functional and cosmetic results were satisfying, with no postoperative lagophthalmos or difficulties with exposure-related problems. Eyelids were successfully grafted and the functions of both eyelids were well recovered, allowing complete cover of the eyeball. ![]() Ten days after surgery, we found that the graft had survived totally, and the donor site of the right arm had already healed. Here, we present the case of a woman who presented second- and third-degree burns of the eyelids secondary to physical domestic assault with acid, who had an early surgical management with a full-thickness skin graft. We propose that early eyelid release and grafting makes a significant difference in long-term outcomes and improves eyeball healing. However, this approach may miss the chance to recover the eyelids and can cause ectropion, resulting in delayed eyeball healing with exposure keratitis. During second- and third-degree eyelid sulfuric acid burns, many surgeons prefer to wait until primary wound separation occurs before grafting. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |