Our chemical burn experience: Exposing the dangers of anhydrous ammonia

Although chemical injuries account for only a small number of one burn unit 's cases, the diversity, resulting complications, and sequelae of these bur ns pose special problems. We reviewed a 19-year period of the chemical burn experience of our burn unit. The population of patients with these types o f burns consisted of young men (mean age: 29.8 years), the majority of whom were injured on the job. Unique to our series is the largest collection of injuries (30%) resulting from the common fertilizer anhydrous ammonia. Ano ther population of concern, accounting for 14% of the injuries in our unit, is that of patients injured at home with routine household cleaners. Nearl y one half of those patients injured at home incurred injuries that require d grafting. The cornerstone of chemical burn prevention and treatment invol ves education regarding the caustic nature of chemicals, proper handling, a dequate protection, and copious irrigation of the wound at the scene. From the analysis of our retrospective review, adequate education and treatment at the scene appear to be well implemented in the industrial and farming co mmunities. The focus of our education efforts should be directed toward the public and emphasize the safe use of household chemicals. Finally our revi ew illuminated the potential benefit of immediate excision and grafting for decreasing the length of stay, complications, and loss of productivity.