Chemical Burn

About Chemical Burn

Chemical burns occur when acids, alkalis, oxidisers or organic compounds contact the skin, eyes or mucous membranes. Severity depends on the chemical, its concentration, contact duration and the area involved. Acid burn treatment requires prolonged irrigation with running water at the scene to dilute and remove the chemical, since deeper injury can continue for hours after exposure if not adequately decontaminated.

On arrival at the hospital, we identify the chemical where possible, complete decontamination and assess depth and area. Eye involvement requires immediate ophthalmology referral. Specific antidotes exist for some agents, such as calcium gluconate gel for hydrofluoric acid, but most chemical injury skin treatment is supportive. Pain control, fluid resuscitation and tetanus cover are addressed early.

Depth assessment is harder than for thermal burns because chemicals can continue to cause damage for some time after exposure. Repeated examination over twenty-four to seventy-two hours often reveals deeper injury than initially suspected. Burn wound care for shallow injuries uses antimicrobial dressings, while deeper wounds need timely debridement to remove non-viable tissue and prevent ongoing chemical injury.

Reconstructive burn surgery in deep chemical burns commonly includes skin grafting, local flap reconstruction and, for extensive injuries, free flap procedures. The face, hands, eyes and genitals receive priority because functional and cosmetic outcomes are most critical there. Surgery is staged where multiple regions are involved, with rehabilitation and pressure therapy starting early to limit scarring and contracture.

Scar maturation continues for one to two years. We use silicone, pressure garments, intralesional injections and laser sessions during this period to manage hypertrophic scars and pigmentation changes. Skin damage repair often requires multiple smaller refinements rather than a single large operation. Patients receive clear written instructions on sun protection, scar massage and follow-up scheduling.

Patients exposed to acid attacks face additional psychological and social challenges. We coordinate with mental health support and community organisations where appropriate. Long-term care includes monitoring for late complications such as restricted breathing through neck contractures, eyelid problems and cosmetic asymmetry. Our team supports patients with structured reviews and individualised plans over the entire reconstructive journey.

What to expect

• Identification of the chemical where possible
• Prolonged irrigation and decontamination
• Assessment of depth, area and special-site involvement
• Antimicrobial dressings or surgical debridement
• Skin grafting and flap reconstruction in deep burns
• Long-term scar management and cosmetic refinement

Recovery

• Re-examination over the first seventy-two hours to confirm depth
• Skin grafting during admission for deeper wounds
• Pressure garments, silicone and sun protection during scar maturation
• Staged refinements across many months for cosmetic outcomes
• Coordinated psychological support where needed