Treatment for Hydrofluoric Acid Chemical Injury on Hands

Purpose: Hydrofluoric acid(HF) is one of the most dangerous mineral acids with dissociated fluoride ions. As hydrofluoric acid is present in various household products(such as rust removers), a large population of industrials is at the risk of HF exposure. It is a very strong organic acid, used widely in glass etching, metal washing, and in the semiconductor industry. Even when using adequate safety measures, lack of care on the user's part results in chemical burn by HF. Symptoms caused by HF-induced chemical burns shows delayed manifestations resulting in a loss of proper treatment opportunities. We therefore reviewed 20 cases of HF-induced chemical burns and treatment principle. Methods: The objects of this study were 19 male patients and 1 female treated from March 2004 to March 2006. There were 19 cases of injury on digits and 1 on the wrist area. There were 15 cases of immediate treatment after sustaining HF-induced burns, and 5 cases of delayed treatment. As a principle, in the emergency treatment, partial or complete removal of the nail along with copious washing with normal saline was done, depending on the degree of HF invasion of the distal digital extremities. Results: The 15 cases who came to the hospital immediately after the injury were healed completely without sequelae, and those who delayed their treatment needed secondary surgical measures, due to the severity of inflammation and necrosis of the digital tissues. Conclusion: As the industrial sector develops, the use of HF is increasing more and more, leading to increase in incidences of HF-induced chemical burns. When treating chemical burns caused by HF, washing by copious amounts of normal saline, along with early removal of the nails, rather than calcium gluconate, seems to be a available method for preserving the shape and function of the digits and the nail. The education of patients regarding this subject should be empathized accordingly.

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