自我化学烧伤的保守治疗:病例报告和文献复习

Amenah Galo, M. Farid, R. Almasharqah
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摘要

引言化学烧伤,特别是与精神疾病有关的伤害,在文献中报道不足。我们报告了两例保守治疗的自行造成的碱化学烧伤。对烧伤进行频繁的临床审查旨在确保适当的愈合,并遵守基于定期换药的治疗计划。病例1:一名24岁女性,在最初受伤的第一天,右前臂出现轻微的自行化学烧伤。病原体是一种含有氢氧化钠的烤箱清洁剂,引发碱烧伤。损伤的表面积为全身表面积(TBSA)全层烧伤的0.5%。患者有复杂的精神病史,被诊断为人格障碍、焦虑和抑郁。病例2:一名55岁女性,左前臂全层烧伤(0.5%TBSA)。这是在最初因含有氢氧化钠的烤箱清洁剂而受伤五天后。该患者有焦虑和抑郁障碍的精神病史。烧伤治疗的主要方法是保守治疗,定期换药和局部用药。通过指定的电子邮件地址为患者提供远程医疗,以进行虚拟临床烧伤审查和任何紧急问题。拍摄了最初烧伤的照片,并安排了诊所就诊,以确定愈合进展。结论自行造成的化学烧伤应在多学科环境中进行管理,包括早期精神科介入。我们提倡采用整体方法来确定保守治疗或手术治疗,同时考虑患者因素、烧伤复杂性和临床医生的判断,以简化治疗计划。由于自残造成的化学烧伤在临床实践中很少见。对两例使用烤箱清洁材料的故意烧伤继发病例的回顾。患者有精神问题,正在服用药物以控制症状。使用常规敷料和外用乳膏进行密切观察可以使烧伤愈合,而无需手术。我们的建议是用敷料治疗这些烧伤,并在诊所定期随访,或者实际上直到痊愈。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The conservative management of self-inflicted chemical burns: Case report and literature review
Introduction Chemical burns, particularly injuries related to psychiatric illnesses, are underreported in the literature. We present two cases of self-inflicted alkali chemical burns managed conservatively. Frequent clinical review of the burn was aimed to ensure appropriate healing and compliance with the treatment plan based on regular dressing changes. Case 1 A 24-year-old woman presented during the first day of the initial injury with a minor self-inflicted chemical burn to the right forearm. The causative agent was an oven cleaner containing sodium hydroxide triggering an alkali-based burn. The surface area of the injury was 0.5% total body surface area (TBSA) full-thickness burn. The patient had a complex psychiatric history diagnosed with personality disorder, anxiety and depression. Case 2 A 55-year-old woman presented with a self-inflicted left forearm full-thickness burn (0.5% TBSA). This was five days after the initial injury from an oven cleaner containing sodium hydroxide. The patient had a psychiatric history of anxiety and depressive disorder. The mainstay of burn management was conservative with regular dressing changes and a topical agent. Telemedicine via a designated email address was given to the patient for virtual clinical burn review and any urgent issues. Photograph of the initial burn was taken, and clinic visits were scheduled to determine healing progress. Conclusion Self-inflicted chemical burns are to be managed within a multidisciplinary setting including early psychiatric involvement. We advocate a holistic approach to determine conservative or operative management, taking into account patient factors, burn complexity and clinician's judgement to streamline the treatment plan. Lay Summary Chemical burns due to self-harm are rare to see in clinical practice. A review of two cases secondary to intentional burns sustained using an oven cleaning material. Patients had psychiatric issues and were on medications to control symptoms. Close observation with regular dressings and topical cream would allow burns to heal without the need for an operation. Our recommendation would be to treat these burns with dressings and regular follow up in the clinic or virtually till healed.
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