Burns
Kenneth D Boffard in Manual of Definitive Surgical Trauma Care: Incorporating Definitive Anaesthetic Trauma Care, 2019
Hydrofluoric acid will continue to injure until the fluorine is chelated. Extreme pain is the hallmark as nerves are irritated. Neuropathic pain is common for months afterwards. After washing the area, the next step is to introduce cations to the injury front. Ca++ and Mg++ are used. Techniques include: Calcium added to gel and applied topically.Calcium gluconate solution added to dimethyl sulfoxide (DMSO) and especially useful for soaking fingertips.Intra-arterial infusion of calcium.Bier's block with calcium gluconate.Hypocalcaemia can result from small areas burned with concentrations >10%. The amount of calcium that may need to be intravenously infused is staggering. Beware!
General principles of resuscitation and supportive care: Burns
David E. Wesson, Bindi Naik-Mathuria in Pediatric Trauma, 2017
Directed treatment of chemical burns based on the specific chemical involved is important for optimizing treatment. Different chemical skin exposures require specific treatment strategies. Hydrofluoric acid should be initially treated with water irrigation and then neutralized with topical calcium gluconate gel. If calcium gluconate gel is not available, it can be made by combining an ampule of calcium gluconate with 100 g of lubricating jelly. Injuries related to phenols (e.g., carbolic acid) are of particular concern because of a risk of absorption and systemic toxicity. Immediate and rapid irrigation with large volumes of water is mandatory because irrigation with smaller amounts of water will dilute the phenol and enlarge the affected area. Children should have liver function tests performed 24 hours after phenol exposure and should be monitored for systemic effects including pulmonary insufficiency, hepatic failure, and renal failure. Tar should initially be solidified with cooling water. Once the tar has hardened, it can be removed with petroleum jelly, a surfactant surface mixture, or a product containing polyoxyethylene sorbitan.
Medical Management of Chemical Warfare Agents
Brian J. Lukey, James A. Romano, Salem Harry in Chemical Warfare Agents, 2019
Two corrosive agents require special mention. The first is sulfur mustard, which has been used extensively in chemical warfare. This agent exerts its effects in a delayed manner. This can cause symptom onset many hours later. As with any chemical agent, the higher the environmental temperature, the more the agent will vaporize. Sulfur mustard is no exception. This allows greater involvement of the mucous membranes and lungs through ingestion and inhalation. Experts believe that the effect is at the DNA level, culminating in cell death and inflammation. One initially sees skin erythema, which progresses to blistering and then, necrosis. The same can occur in the pulmonary tree. The other agent is hydrofluoric acid, commonly used in the electronics industry. While as a weak acid it can cause chemical burns, its more important property is that it binds up intracellular calcium and magnesium. This causes severe neuropathic-type burning pain and interferes with muscle functioning, including the cardiac myocardium. Although it is an acid, it can burn more deeply because it is weak and does not cause the dense scabbing.
Fate of GdF3 nanoparticles-loaded PEGylated carbon capsules inside mice model: a step toward clinical application
Published in Nanotoxicology, 2020
Binapani Mahaling, Madhu Verma, Gargi Mishra, Surabhi Chaudhuri, Debjani Dutta, Sri Sivakumar
Tetraethyl orthosilicate (TEOS), n-octadecyltrimethoxysilane (C-18 TMS), gadolinium nitrate hexahydrate (Gd(NO3)3·6H2O), bis-amino polyethylene glycol (PEG) (6000 kDa), trypsin-EDTA, Dulbecco’s-modified eagle’s medium (DMEM), penicillin–streptomycin antibiotic, N3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), phosphate buffer saline (PBS), gelatin (from cold water fish skin), and Gadolinium (Gd) standard were purchased from Sigma-Aldrich. Sulfuric acid (H2SO4), nitric acid (HNO3), ethanol, triton X-100, dimethylformamide (DMF), and dimethyl sulfoxide (DMSO) were obtained from Merck Chemicals, India. Hydrofluoric acid (HF), and sodium fluoride (NaF) were obtained from SD. Fine Chem. Ltd, India. Ammonium fluoride (NH4F), ethylenediaminetetraacetic acid (EDTA), and oleic acid were obtained from Loba Chemie, India. Sodium chloride (NaCl), sodium hydroxide (NaOH), methanol, hydrogen peroxide (H2O2) (30% w/v in water), and aqueous ammonia (25% v/v) were purchased from Fisher Scientific. Cell ROX-Alexafluor-488 reagent and Annexin-V-Alexafluor-488 reagent were purchased from Thermo Fisher Scientific. All the above chemicals were used as received. HeLa, NIH3T3, NRK-49F, MCF-7, HepG2 and PC3 cell lines were purchased from National Center for Cell Science, Pune, India.
Novel pharmacotherapy for burn wounds: what are the advancements
Published in Expert Opinion on Pharmacotherapy, 2019
While thermal injury is by far the most common cause of burns, it should not be forgotten that burns can also be caused by chemicals, electrical contact, and radiation. These types of burns have some particular features that may affect the prognosis and treatment [23]. According to the 2015 report of the American Burn Association, chemical injuries represented 3.4% of patients admitted to participating hospitals during the 2004 to 2015 period. Acids, alkalis, hydrofluoric acid, white phosphorous, and phenol are the commonest chemical agents, and burns caused by some of these materials may require special measures. Electrical injuries comprise 4% of all reported burns. Although electrical injuries cause mainly external injuries, they can also cause internal burns caused by the current passing through bones and muscles inside the body. Radiation burns nowadays are usually associated with cancer treatment, and are complicated by the hematologic consequences of radiation exposure.
Hydroxyapatite as a biomaterial – a gift that keeps on giving
Published in Drug Development and Industrial Pharmacy, 2020
Behrad Ghiasi, Yahya Sefidbakht, Sina Mozaffari-Jovin, Behnaz Gharehcheloo, Mehrnoush Mehrarya, Arash Khodadadi, Maryam Rezaei, Seyed Omid Ranaei Siadat, Vuk Uskoković
Combination of HA with metallic implants is one strategy for creating implants with more promising properties. Table 2 sums up some of the examples of implants containing HA as one of their components and also lists some of their key structural features and properties. For instance, HA can be coated onto the surface of metallic implants using various methods, such as biomimetic precipitation from simulated body fluid [124], sol gel [125,126], electrophoretic deposition [112], pulsed laser deposition [127], plasma spray [128], or sputtering techniques [129]. Among the metallic implants, titanium and its alloys have been most widely used as implants due to the lower elastic modulus, biocompatibility, mechanical properties, and excellent corrosion resistance . However, they are bioinert and to render them bioactive, coating with HA is a strategy often resorted to. This is, of course, not the only way to increase the bioactivity of metallic implants and improve their osseointegration. For example, methods such as hydrofluoric acid treatment [130] and collagen coating [131] have been used with success. However, among multiple physical and chemical methods for modifying the surface of metallic implants, the deposition of HA still stands forth as one of the simplest and most economical of methods. By chemically modifying the surface, it goes beyond the simple imposition of topographic changes via etching, while it is also less expensive and less immunologically risky approach compared to that of amending the surface with proteins.
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