Pain Control for Hydrofluoric Acid Chemical Burn Using EMLA(R) Creams.

Choi, Hwan Jun; Song, Jin Woo; Choi, Chang Yong

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(1):113-117.
Published online January 1, 2009.

Pain Control for Hydrofluoric Acid Chemical Burn Using EMLA(R) Creams.

Hwan Jun Choi, Jin Woo Song, Chang Yong Choi

Department of Plastic and Reconstructive Surgery College of Medicine, Soonchunhyang University, Gyeongbuk, Korea. medi619@hanmail.net

Abstract

PURPOSE
Although Hydrofluoric acid(HF) is not a strong acid compared to other hydrogen halides, it is a feared corrosive and is particularly dangerous in higher concentrations. HF burns are characterized by symptoms, often delayed and localized with diluted HF solutions, to include erythema, edema and severe pain. Pain, a well known symptom, is followed by exposure to calcium binding. And, EMLA(R) cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to relieve pain undergoing superficial surgical procedures. The aim of this study is to evaluate effects of EMLA(R) cream, pain-control dressing on the treatment for HF injury wound. METHODS: From June 2007 to June 2008, this study was carried out with 10 patients who had HF partial thickness burns. We were applied topically EMLA(R) cream to injured wound with vaseline gauze and 10% calcium gluconate wet gauze dressings. As a principle, in the emergency treatment, partial or complete removal of the bullae along with copious washing with normal saline was done, depending on the degree of HF invasion of the distal digital extremities. The effect of dressing was investigated by visual analogue pain scale.
RESULTS
We therefore reviewed 10 cases of HF- induced pain and pain relief treatment principle. The 10 cases who came to the hospital nearly immediately after the injury healed completely without sequelae and EMLA(R) related complications.
CONCLUSION
Proper initial treatment of HF burn is important. If not promptly recognized or properly treated, it produces serious injury. Topical EMLA(R) cream remains a powerful, new advancement for minimizing HF-related pain during dressing procedures. When used appropriately, topical EMLA(R) cream can be a safe and effective alternative to other forms of HF-pain control treatment.

Keywords: Hydrofluoric acid; Chemical burn; EMLA(R) cream

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