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Volume 38 Issue 2
Feb.  2022
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Article Navigation >  CHINESE JOURNAL OF BURNS AND WOUNDS  > 2022  >  38(2): 156-164
Zhang MJ,Mao SL,Zhang JF,et al.Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands[J].Chin J Burns Wounds,2022,38(2):156-164.DOI: 10.3760/cma.j.cn501120-20210517-00188.
Citation: Zhang MJ,Mao SL,Zhang JF,et al.Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands[J].Chin J Burns Wounds,2022,38(2):156-164.DOI: 10.3760/cma.j.cn501120-20210517-00188.
shu

Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands

doi: 10.3760/cma.j.cn501120-20210517-00188
  • 1.

    The First Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou 310053, China

  • 2.

    Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China

  • 3.

    Department of Burn and Wound Repair, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China

Funds:

National Key Research and Development Program of China 2018YFC0808600

Applied Research Plan of Commonweal Technology of Zhejiang Province of China 2017C33186

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  • Corresponding author: Zhang Yuanhai, Email: zyhssk@163.com
  • Received Date: 2021-05-17
    Abstract
  •     Objective   To explore the epidemiological characteristics and treatment outcomes of patients with hydrofluoric acid burns in hands.    Methods   A retrospective observational study was conducted. The medical records of 229 patients with hydrofluoric acid burns in hands who were admitted to Zhejiang Quhua Hospital from January 2008 to December 2020 and met the inclusion criteria were collected. The following statistical data of patients were collected, including gender, age, type of affiliated enterprise, hydrofluoric acid mass fraction, injury site, total burn area, prehospital time, length of hospital stay, length of wound healing, whether hypocalcemia and hypomagnesemia occurred or not on admission, whether surgery intervention was performed or not, and whether scar sequelae occurred or not. Single factor and multivariate logistic regression analysis were used to screen out the risk factors impacting surgery intervention and scar sequelae of all the patients and patients whose hydrofluoric acid mass fraction was known. Single factor and multivariate linear regression analysis were used to screen out the risk factors impacting the length of wound healing of all the patients and patients whose hydrofluoric acid mass fraction was known.    Results   The 229 patients included 206 males and 23 females, with the majority aged 30 to 50 years (139 patients). The type of affiliated enterprise of majority patients was non-fluorine chemical enterprise. The hydrofluoric acid mass fraction was known in only 91 patients, mainly medium. The majority injury site was in the middle and end of finger. The total burn area was below or equal to 1% total body surface area. The prehospital time was 19 (9, 29) h. The length of hospital stay was 2 (1, 7) d. The length of wound healing was 12 (8, 18) d. The proportions of hypocalcemia and hypomagnesemia were 0.9% (2/229) and 1.3% (3/229) on admission, respectively. Thirty-six patients had surgeries and 83 patients had scar sequelae. In 229 patients, single factor logistic regression analysis showed that both type of affiliated enterprise and prehospital time were the factors impacting surgery intervention (with odds ratio values of 7.86 and 51.35, respectively, 95% confidence intervals of 1.83-33.76 and 11.89-221.78, respectively, P<0.01) and scar sequelae of patients (with odds ratio values of 3.62 and 27.40, respectively, 95% confidence intervals of 1.76-7.43 and 13.25-56.68, respectively, P<0.01); multivariate logistic regression analysis showed that prehospital time was the independent risks factor impacting surgery intervention and scar sequelae of patients (with odds ratio values of 43.00 and 24.55, respectively, 95% confidence intervals of 9.89-187.03 and 11.78-51.16, respectively, P<0.01); single factor linear regression analysis showed that both type of affiliated enterprise and prehospital time were the factors impacting the length of wound healing of patients (with β values of 6.16 and 12.83, respectively, 95% confidence intervals of 3.38-8.93 and 10.72-14.93, respectively, P<0.01); multivariate linear regression analysis showed that both type of affiliated enterprise and prehospital time were the independent risk factors impacting the length of wound healing of patients (with β values of 2.81 and 12.16, respectively, 95% confidence intervals of 0.50-5.13 and 10.00-14.31, respectively, P<0.05 or P<0.01). In 91 patients whose hydrofluoric acid mass fraction was known, single factor logistic regression analysis showed that type of affiliated enterprise, hydrofluoric acid mass fraction (low and high), and prehospital time were all the factors impacting surgery intervention of patients (with odds ratio values of 9.10, 11.25, 10.69, and 0.04, respectively, 95% confidence intervals of 1.15-72.25, 1.39-90.93, 1.32-86.59, and 0.01-0.19, respectively, P<0.05 or P<0.01), type of affiliated enterprise, hydrofluoric acid mass fraction, and prehospital time were all the factors impacting scar sequelae of patients (with odds ratio values of 0.32, 0.21, and 36.80, respectively, 95% confidence intervals of 0.11-0.92, 0.06-0.73, and 11.03-122.79, respectively, P<0.05 or P<0.01); multivariate logistic regression analysis showed that both hydrofluoric acid mass fraction and prehospital time were the independent risk factors impacting surgery intervention of patients (with odds ratio values of 11.51 and 0.04, respectively, 95% confidence intervals of 1.22-108.26 and 0.01-0.25, respectively, P<0.05 or P<0.01), prehospital time was the independent risk factor impacting scar sequelae of patients (odds ratio=37.71, with 95% confidence interval of 9.97-142.69, P<0.01); single factor linear regression analysis showed that type of affiliated enterprise, hydrofluoric acid mass fraction (low and high), and prehospital time were all the factors impacting the length of wound healing of patients (with β values of 7.12, -5.63, -9.74, and 13.50, respectively, 95% confidence intervals of 2.43-11.81, -10.59--0.68, -14.78--4.70, and 10.14-16.86, respectively, P<0.05 or P<0.01); multivariate linear regression analysis showed that both hydrofluoric acid mass fraction and prehospital time were the independent risk factors impacting the length of wound healing of patients (with β values of -5.84 and 0.09, respectively, 95% confidence intervals of -10.59--1.08 and 0.05-0.12, respectively, P<0.05 or P<0.01).    Conclusions   The majority of patients with hydrofluoric acid burns in hands are young and middle-aged males. Type of affiliated enterprise, hydrofluoric acid mass fraction and prehospital time are the risk factors that affect the treatment outcomes of patients with hydrofluoric acid burns in hands.

     

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    • References(31)
  • [1]
    HoffmannS, ParikhP, BohnenbergerK. Dermal hydrofluoric acid toxicity case review: looks can be deceiving[J].J Emerg Nurs,2021,47(1):28-32.DOI: 10.1016/j.jen.2020.08.005.
    [2]
    YeCJ, WangXG, ZhangYH, et al. Ten-year epidemiology of chemical burns in western Zhejiang Province, China[J]. Burns,2016,42(3):668-674.DOI: 10.1016/j.burns.2015.12.004.
    [3]
    ZhangYH, ZhangJF, JiangXH, et al. Hydrofluoric acid burns in the western Zhejiang Province of China: a 10-year epidemiological study[J]. J Occup Med Toxicol, 2016,11:55. DOI: 10.1186/s12995-016-0144-3.
    [4]
    毛新兴,王新刚,张元海,等.重大氢氟酸泄漏事故中成批患者的救治[J].中华烧伤杂志,2015,31(5):381-383.DOI: 10.3760/cma.j.issn.1009-2587.2015.05.015.
    [5]
    ZhangYH, WangXG, SharmaK, et al. Injuries following a serious hydrofluoric acid leak: first aid and lessons[J].Burns,2015,41(7):1593-1598.DOI: 10.1016/j.burns.2015.04.002.
    [6]
    张元海,王新刚,田鹏飞,等.改良葡萄糖酸钙给药剂量对非手足部的氢氟酸烧伤患者的治疗效果分析[J].中华烧伤杂志,2018,34(5):277-282.DOI: 10.3760/cma.j.issn.1009-2587.2018.05.005.
    [7]
    张元海,田鹏飞,张惟,等.急救网络建设在危重氢氟酸烧伤患者早期救治中的作用[J].中华烧伤杂志,2021,37(10):921-928.DOI: 10.3760/cma.j.cn501120-20210707-00237.
    [8]
    马捷,邓津菊,吴健,等.氢氟酸烧伤的临床表现及治疗进展[J/CD].中华损伤与修复杂志:电子版,2019,14(6):466-470.DOI: 10.3877/cma.j.issn.1673-9450.2019.06.015.
    [9]
    张伟,李晓明,张兴国,等.氢氟酸烧伤致骨质缺如一例[J].中华劳动卫生职业病杂志,2020,38(11):864-865.DOI: 10.3760/cma.j.cn121094-20191008-00466.
    [10]
    Bajraktarova-ValjakovaE, Korunoska-StevkovskaV, GeorgievaS, et al. Hydrofluoric acid: burns and systemic toxicity, protective measures, immediate and hospital medical treatment[J]. Open Access Maced J Med Sci, 2018,6(11):2257-2269. DOI: 10.3889/oamjms.2018.429.
    [11]
    田鹏飞,张建芬,胡祖良,等.浙西地区316例职业性氢氟酸灼伤病例流行病学分析[J].环境与职业医学,2018,35(6):578-581.DOI: 10.13213/j.cnki.jeom.2018.17631.
    [12]
    TianPF, ZhangYH, WengTT, et al. Epidemiology of work-related hydrofluoric acid exposure in western Zhejiang Province, China[J]. J Clin Toxicol, 2018, 8(6):398.DOI: 10.4172/2161-0495.1000398.
    [13]
    How do I diagnose and treat workers with injuries from hydrofluoric acid?[J]. J Occup Environ Med, 2016,58(7):e275-277.DOI: 10.1097/JOM.0000000000000762.
    [14]
    WangXG, ZhangYH, NiLF, et al. A review of treatment strategies for hydrofluoric acid burns: current status and future prospects[J]. Burns, 2014, 40(8):1447-1457. DOI: 10.1016/j.burns.2014.04.009.
    [15]
    王新刚, 张元海, 韩春茂. 氢氟酸烧伤治疗研究进展[J]. 中华烧伤杂志, 2013, 29(4): 371-374. DOI: 10.3760/cma.j.issn.1009-2587.2013.04.011.
    [16]
    王新刚,张元海,韩春茂.氢氟酸烧伤的致伤机制及其治疗的研究进展[J].中华急诊医学杂志,2014,23(11):1295-1297.DOI: 10.3760/cma.j.issn.1671-0282.2014.11.029.
    [17]
    WangSY, DaiGW.Hydrofluoric acid burn[J].CMAJ,2019,191(11):E314.DOI: 10.1503/cmaj.181078.
    [18]
    LippertJ,DesaiB,FalgianiM,et al. Management of hydrofluoric acid burns in the emergency department[J]. Cureus,2020,12(3):e7152.DOI: 10.7759/cureus.7152.
    [19]
    RieselJN, GiladiAM, IorioML. Volar resurfacing of the thumb with a superficial circumflex iliac artery perforator flap after hydrofluoric acid burn[J]. J Hand Microsurg, 2018,10(3):162-165.DOI: 10.1055/s-0038-1630146.
    [20]
    ParkSE, LeeJY, KimCW, et al. Hydrofluoric acid burn on a fingertip treated successfully with single session of subcutaneous injection of 6.7% calcium gluconate[J]. Ann Dermatol,2016,28(5):639-640.DOI: 10.5021/ad.2016.28.5.639.
    [21]
    KimDY, KimDW, DhongES. Early surgical treatment by free flap reconstruction of hydrofluoric acid burn injury[J]. J Plast Reconstr Aesthet Surg, 2015,68(10):1477-1478. DOI: 10.1016/j.bjps.2015.05.022.
    [22]
    ZhangYH, ZhangJF, WangXG. Treatment of hydrofluoric acid burns of the fingers[J].J Plast Reconstr Aesthet Surg, 2016,69(3):436-437. DOI: 10.1016/j.bjps.2015.11.026.
    [23]
    KimDY, KimDW, DhongES. Reply: treatment of hydrofluoric acid burns of the fingers[J]. J Plast Reconstr Aesthet Surg, 2016,69(4):582-583. DOI: 10.1016/j.bjps.2015.12.017.
    [24]
    HanHH, KwonBY, JungSN, et al. Importance of initial management and surgical treatment after hydrofluoric acid burn of the finger[J]. Burns,2017,43(1):e1-e6. DOI: 10.1016/j.burns.2016.07.031.
    [25]
    ZhangYH, ZhangJF, NiLF, et al. Rational treatment of hydrofluoric acid burns of the fingers[J]. Burns, 2018, 44(8): 2099-2100. DOI: 10.1016/j.burns.2017.05.027.
    [26]
    HanHH, KwonBY, JungSN, et al. Response to letter to the editor "rational treatment of hydrofluoric acid burns of the fingers"[J].Burns, 2018, 44(8): 2100-2101.DOI: 10.1016/j.burns.2017.06.002.
    [27]
    HatzifotisM, WilliamsA, MullerM, et al. Hydrofluoric acid burns[J]. Burns, 2004, 30(2):156-159.DOI: 10.1016/j.burns.2003.09.031.
    [28]
    刘利平,张元海,蒋瑞明,等.葡萄糖酸钙凝胶治疗手足部氢氟酸烧伤的疗效观察[J].中华烧伤杂志,2014,30(1):67-69.DOI: 10.3760/cma.j.issn.1009-2587.2014.01.018.
    [29]
    张建芬,吴晓霞,吴军梅,等.动脉灌注葡萄糖酸钙治疗手部氢氟酸灼伤的疗效和安全性[J].环境与职业医学,2018,35(8):725-728.DOI: 10.13213/j.cnki.jeom.2018.18215.
    [30]
    ZhangYH, NingLF, WangXG, et al. Clinical arterial infusion of calcium gluconate: the preferred method for treating hydrofluoric acid burns of distal human limbs[J]. Int J Occup Med Environ Health, 2014,27(1):104-113. DOI: 10.2478/s13382-014-0225-4.
    [31]
    ZhangYH, WangXG, YeCJ, et al. The clinical effectiveness of the intravenous infusion of calcium gluconate for treatment of hydrofluoric acid burn of distal limbs[J]. Burns, 2014, 40(4): e26-30. DOI: 10.1016/j.burns.2013.12.003.
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