Throughout your life, it’s likely that you’ve burned yourself in some way or another. Whether you accidentally touched a hot stove or been out in the sun too long, burns are very common injuries. However, chemical burns are not as common. Chemical burns, also known as caustic burns, are those that are sustained through contact with an irritant such as an acid or base. This can lead to tissue destruction and severe irritation. There are many different types of chemicals that can lead to chemical burns, as well as a variety of environments that they can be sustained in.
Types of Chemicals
Depending on where you spend your time every day, you may be more susceptible to receiving a chemical burn than another person might be. For example, some of the most common locations with harmful chemicals include in laboratories and industrial workplaces. However, chemical burns are still possible in your home, as many household cleaning items contain strong irritants. In some cases, chemical burns may also be the result of assault.
Some of the most common chemicals that result in chemical burns include ammonia, sulfuric acid, sodium hydroxide, potassium hydroxide, hydrochloric acid, nitric acid, lime, and silver nitrate1.
Regardless of the location that you received a chemical burn, the types of possible injuries from common chemicals remain constant.
Types of Chemical Burn Injuries
- Initial Burn Wound
When you first come into contact with a chemical irritant, the first thing that happens is a traditional burn. However, chemical burns are deeper and more severe than the average thermal burn. Symptoms include itching, the bleaching or darkening of skin, and tissue necrosis or tissue death. You should immediately irrigate the area of the chemical burn to prevent more extensive damage, as the longer that the chemical sits on the skin the worse the burn may get. After the initial burn, further injury can happen, too1.
After the initial bodily response from the chemical burn, it’s not uncommon to enter shock. Shock is a type of abnormal physiological state where oxygen delivery is significantly compromised, and fluid accumulation is profound. This is due to the release of stress hormones like catecholamines and cortisones, as well as inflammatory cytokines. Shock is a severe medical emergency that can cause a decrease of cardiac and tissue function2.
- Hypermetabolic State
When you sustain a chemical burn, your body is put in an overactive and stress-induced state. However, within 72 to 96 hours of incidence, your body will likely enter a hypermetabolic state if the burn was severe. This involves increased cellular stress and dysfunction which is characterized by a decreased metabolic rate. Further, you may have low cardiac output and intravascular volume. This can last up to 36 months post-burn depending on severity2.
- Immune Dysregulation
One of the major consequences of chemical burn injuries is immune dysregulation and infection. This is because immune cells are typically activated in response to injury. This immune response involves the release of chemicals that are supposed to encourage inflammation to protect the injured area. In many cases, fever, hypothermia, and tachycardia can develop due to this systemic inflammatory response2.
Chemical burns leave wounds on the body. When there is an open wound, this acts as an entry point for bacteria and germs into the body. If not properly cared for, burns can get infected relatively easily. Different types of infections including bacterial, yeast, and fungal infections, are possible. In fact, in about 60 percent of chemical burn cases that result in death display signs of infection2.
- Inhalation Injuries
As the name suggests, inhalation injuries occur when you accidentally inhale an irritating chemical. The severity of inhalation injuries can vary between minor to severe with patterns of necrotic behavior, or tissue death. This form of injury is one of the more difficult forms of chemical injuries to treat, as the burn is located internally. Patients may require specialized testing to determine the true effect of the burn. Symptoms often include pulmonary complications, pneumonia, and an increased fluid intake requirement. Unfortunately, cases of inhalation injury may frequently end in death due to their complex nature2.
One less common, but still prevalent, form of chemical burn occurs to the eye. Exposure might occur through gas or chemical vapors entering the eye. If chemicals come into contact with the eye area, eyelid function and vision may suffer. This could ultimately lead to further infection and irritation2.
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