Phosphorus burns are a rarely encountered
chemical burn, typically occurring in battle, industrial accidents, or from fireworks. Death may result even with minimal
burn areas. Early recognition of affected areas and adequate
resuscitation is crucial. Amongst our 2765 admissions between 1984 and 1998, 326 patients had
chemical burns. Seven admissions were the result of
phosphorus burns. Our treatment protocol comprises 1%
copper sulfate solution for neutralization and identification of
phosphorus particles, copious
normal saline irrigation, keeping
wounds moist with saline-soaked thick pads even during transportation, prompt
debridement of affected areas, porcine skin coverage or skin grafts for acute
wound management, as well as intensive monitoring of
electrolytes and cardiac function in our
burns center. Intravenous
calcium gluconate is mandatory for correction of
hypocalcemia. Of the seven, one patient died from inhalation injury and the others were scheduled for sequential
surgical procedures for functional and cosmetic recovery. Cooling affected areas with tap water or
normal saline, prompt removal of
phosphorus particles with mechanical
debridement, intensive monitoring, and maintenance of electrolyte balance are critical steps in initial management. Fluid
resuscitation can be adjusted according to urine output. Early excision and skin autografts summarize our
phosphorus burn treatment protocol.