Acid attacks

Perhaps unbelievably (or not?), the UK has some of the highest worldwide rates (!!!) of acid attacks...

  • used to be honour-related, directed at women etc
  • UK stats suggest more likely to be gang related, against men and boys
  • corrosive substances = "highly dangerous weapons"

history

  • What substance? first aid?
  • any other trauma associated?

similar management approach to burns

  • remove the source
  • irrigation while keeping patient warm
    • until stable pH
    • water, Hartmann's, diphoterine if you can get it = amphoteric
  • refer all chemical burns to specialist burns unit
  • safeguarding

pathogenesis

  • coagulative necrosis - hence damage takes time to show
  • alkali:
    • lipophilic
    • saponification of fatty acids
    • proteolytic enzymes from damaged tissue = more damage