Dr Wiktor Pilch¹, Dr Hollie Moran¹, Dr Patrick Coghlan¹, Associate Professor Marcus Wagstaff¹

¹Royal Adelaide Hospital Adult Burns Service, Adelaide, Australia

Abstract:

Sulphuric acid (H2SO4) burns can cause significant injury resulting in disability, inability to work, disfigurement and pain. Chemical burns frequently occur in industries that lack access to appropriate, effective first aid.

Diphoterine® is a water-soluble powder manufactured by Laboratoire Prevor (Valmondois, France) as a spill-kit and is provided for use dissolved in water. It is a polyvalent (actively binding to multiple substances), amphoteric, hypertonic chelating molecule with active binding sites for various substances including acids and alkalis (1).

The use of Diphoterine® has been shown to decrease the severity and pain of chemical burns, by chemical decontamination resulting in; fewer requirements for surgical burn care other than initial decontamination and, a reduced time off work (2).

We found a lack of awareness amongst a representation of tradespeople, of 54 surveyed, 27/54 (50%) used a high concentration sulphuric acid, yet 0/54 (0%) had a spill kit, or heard of Diphoterine®.

We present a case of 63 year old male chemical-transport mine worker, admitted to a major burns centre with 2% facial burns caused by 98% concentrated sulphuric acid. Due to water scarcity, immediate first aid utilised the chelating agent Diphoterine®.

He progressed expectantly on the ward without requiring surgical intervention and was discharged uneventfully highlighting the option and efficacy of early Diphoterine® use in sulphuric acid burns.

We review the current literature on the effect of Diphoterine®  and determined a lack of education and prevalence of chelating agents in Australia, particularly in industries with usage of high concentration acids.

Biography:

Dr Wiktor Pilch is a Plastic and Reconstructive Surgery Unaccredited Registrar working in Adelaide, South Australia.