Serious Burn by Sulfuric Acid: Case Report of Particular Therapeutic Strategy in a Non-Specialized ICU at H？pital Principal de Dakar (HPD) Sénégal

Managing severe burns remains problematic due to the lack of specialized units, but also because of the delay in implementing emergency care. The aim is to show that an adapted strategy, can lead to satisfying management of chemical burns. The authors report retrospectively the case of a patient admitted for chemical burns, and treated in a non-specialized intensive care unit; a 38 years old male, referred for burns by sulfuric acid at his workplace. On admission to H15, the clinic did not reveal any vital organs failure. Burns were localized on two legs and soles of the two feet (18% TBSA). Treatment combined daily dressings with silver sulfadiazine. On day 14, the wound healing associated occlusive gauze dressing, iodine cream application, and mechanical debridement. On day 47, a 5% dermal autograft performed on right foot favored with good attachment grafts. On day 58, the patient was released after complete skin recovery. Then, in a non-specialized burn unit and without early surgery access, our wound healing adapted strategy was successful. In Senegal, chemical burns represent about 2.5% of burn cases. They are often from accidents on occupation job, while generally in Africa chemical burns result from criminal attacks. Patients with severe lesions are admitted in non-specialized environments after an extended time of transfer, and don’t have efficient initial care. This may explain the high morbidity and mortality after burns in our country. The lack of surgical facilities such as skin substitutes, in non-specialized unit on low or median income countries (LMICs), explains this long period of wound healing. The treatment of severe burn in LMICs is hazardous.