The management of white phosphorus burns

Trong Duo Chou, Tz Win Lee, Shao Liang Chen, Yeou Ming Tung, Nai Tz Dai, Shyi Gen Chen, Chiu Hong Lee, Tim Mo Chen, Hsian-Jenn Wang

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38 Citations (Scopus)

Abstract

Phosphorus burns are a rarely encountered chemical burn, typically occurring in battle, industrial accidents, or from fireworks. Death may result even with minimal burn areas. Early recognition of affected areas and adequate resuscitation is crucial. Amongst our 2765 admissions between 1984 and 1998, 326 patients had chemical burns. Seven admissions were the result of phosphorus burns. Our treatment protocol comprises 1% copper sulfate solution for neutralization and identification of phosphorus particles, copious normal saline irrigation, keeping wounds moist with saline-soaked thick pads even during transportation, prompt debridement of affected areas, porcine skin coverage or skin grafts for acute wound management, as well as intensive monitoring of electrolytes and cardiac function in our burns center. Intravenous calcium gluconate is mandatory for correction of hypocalcemia. Of the seven, one patient died from inhalation injury and the others were scheduled for sequential surgical procedures for functional and cosmetic recovery. Cooling affected areas with tap water or normal saline, prompt removal of phosphorus particles with mechanical debridement, intensive monitoring, and maintenance of electrolyte balance are critical steps in initial management. Fluid resuscitation can be adjusted according to urine output. Early excision and skin autografts summarize our phosphorus burn treatment protocol.

Original languageEnglish
Pages (from-to)492-497
Number of pages6
JournalBurns
Volume27
Issue number5
DOIs
Publication statusPublished - Jul 26 2001
Externally publishedYes

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Keywords

  • Chemical burn
  • Copper sulfate
  • Hypocalcemia
  • White phosphorus

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

Cite this

Chou, T. D., Lee, T. W., Chen, S. L., Tung, Y. M., Dai, N. T., Chen, S. G., Lee, C. H., Chen, T. M., & Wang, H-J. (2001). The management of white phosphorus burns. Burns, 27(5), 492-497. https://doi.org/10.1016/S0305-4179(01)00003-1