Burn with hydrogen peroxide

Hydrogen peroxide is a substance known to many: a transparent liquid that does not have a color and is practically odorless, is found in almost every home medicine cabinet. As a rule, this is a 3% solution, which is used for external treatment of wounds and cuts. Significant superficial burns such solution does not cause, moreover, it can be treated with some thermal burn wounds. If you take this drug inside, you can get an internal burn with hydrogen peroxide, since the mucosa of the digestive tract is much more sensitive to the effects of chemicals.

External burns of the skin can be obtained if you shed a concentrated solution on the body - perhydrol, which is a 27.5-31% liquid. There is also a technical version of the solution, which has about 40% concentration.

[1]

Epidemiology

Burns with hydrogen peroxide, according to some data, account for approximately 5% of all burns by chemicals.

The lethal amount of drunk perhydrol (30%) can be from 50 to 100 ml.

[2], [3], [4], [5], [6], [7]

Causes of the hydrogen peroxide burn

Burns are often found with internal use of hydrogen peroxide, as well as in inaccurate handling of a solution that is used for clarifying tissues, in printing, in aviation, in medicine.

[8], [9]

Risk factors

Risk factors can be the following:

• work associated with the use of concentrated perhydrol;
• non-compliance with safety regulations at chemical plants;
• storage of medicines in places accessible to children;
• accidental ingestion of solution, split bottle, etc.

Also, a burn can be obtained with an incorrect approach to hair coloring, because some paints are supplemented with a solution of peroxide with a concentration of 6% or even 9%, which is 2-3 times higher than the concentration of a usual pharmacy solution.

[10], [11], [12], [13], [14], [15]

Pathogenesis

Hydrogen peroxide has the ability to enter into oxidation and reduction reactions with the release of atomic oxygen. Visually, this process can be observed as a lightening of pigmented or colored areas. The released oxygen can destroy the bacteria. For the human body, the main danger is concentrates - for example, perhydrol, which can cause burn damage to skin and mucous membranes.

The main number of burns with hydrogen peroxide is caused by the use of liquid inside. In contact with the mucous tissue, the solution decomposes, releasing oxygen, since peroxide is a strong oxidant. The most aggressive oxidizer is perhydrol.

In the case of hydrogen peroxide damage, there is a pronounced destruction of the mucous membranes and skin, which can be compared with a burn from alkalis.

Deep internal burns of mucous and submucosal tissue can damage blood vessels, which creates the risk of oxygen gas entering the general bloodstream followed by gas embolism of the cerebral vascular bed or heart.

[16], [17], [18], [19], [20], [21]

Symptoms of the hydrogen peroxide burn

Usually physicians distinguish three main signs of a burn with a concentrate of hydrogen peroxide:

• whitening or redness of the skin;
• edema;
• the appearance of blisters.

The most complete description of the clinical picture can be obtained by evaluating the different types of peroxide burns individually.

• The burn with hydrogen peroxide of the skin is accompanied by a pallor of the upper layer, pain of varying intensity (depending on the degree of tissue damage). In more severe cases, bubbles appear, the necrosis of the outer cover. When the wound surface is healed, scars form.
• The burn with hydrogen peroxide of the oral cavity immediately reveals itself with severe pain. This happens when using peroxide with a concentration of more than 6-10%. Visually, the area of damage is clearly visible. The color of the affected area is white. In the future, moist necrosis is formed, the tissues become loose, which further contributes to penetration of the chemical substance deep into the interior. Scars after healing, as a rule, are more massive and deep.
• A burn of the eye with hydrogen peroxide of great concentration threatens a complete loss of vision in the affected organ. If you get a usual chemist's solution, you immediately feel a burning sensation, there is irritation, "fog" in the eyes, photophobia, lacrimation. Conjunctiva blushes, pain first increases, then gradually passes (for several hours). If the corneal layer burns, the last cloud becomes cloudy, bubbles may appear in the stroma.

With the action of a solution of a higher concentration (over 10%), ulcers and perforations of the cornea occur.

• The burn of the throat with hydrogen peroxide occurs with the occasional use of more concentrated solutions than provides for treatment. As a rule, when the throat is rinsed, 3% of the liquid does not burn.

If the rinse used a solution more than 10%, then in the throat there are pain, lightening or reddening of the mucous membranes, swelling. In severe cases, the tissue is necrotic.

With the occasional use of perhydrol inwards, a burn of the esophagus and stomach can occur, which subsequently often leads to stenosis and the inability to swallow food.

[22], [23], [24], [25]

Stages

Burns with concentrated hydrogen peroxide can be conditionally divided into several clinical groups, or stages:

• Stage I is characterized by a slight reddening, swelling of the tissues. In this case, the affected area is clearly delineated. The first signs of stage I are drawing pain and burning;
• II stage is accompanied by significant reddening, destruction of cutaneous epithelium and surface layers of tissue, the appearance of blisters. A characteristic sign of stage II is severe pain;
• III stage - a necrosis of superficial tissue, a cardinal change in its color, unbearable pain, swelling and hyperemia of the nearby zone;
• IV stage is characterized by death of the skin, complete necrosis of the underlying fat layer, muscle fibers.

[26], [27]

Complications and consequences

Deep burns with concentrated hydrogen peroxide can lead to undesirable systemic and local consequences:

• shock state, toxemia;
• when ingested - damage to the mucosa of the esophagus and digestive tract;
• violation of the function of the urinary system;
• violation of water-salt balance;
• coma;
• tissue necrosis;
• when the eyes are affected - corneal opacity, deterioration or loss of vision.

Among the long-term consequences can be called a rough cicatricial deformation of the lesion, articular contractures, trophic disorders. These problems often require the intervention of a surgeon or orthopedist.

[28], [29], [30], [31], [32]

Diagnostics of the hydrogen peroxide burn

Laboratory diagnostics includes the following tests:

• determination of blood pH, biochemistry, concentration of electrolytes in blood serum;
• general urine analysis.

When ingesting hydrogen peroxide, metabolic acidosis may develop. In addition, kidney and metabolic disorders should be excluded.

Instrumental diagnostics can consist of a number of studies:

• X-ray examination of the chest and abdominal cavity to exclude perforation of the digestive tract;
• computed tomography and ultrasound;
• X-ray examination using contrast medium (for diagnosis of narrowing of digestive tracts);
• endoscopic examination (actual during the first day after internal use of hydrogen peroxide).

[33], [34], [35], [36], [37]

Differential diagnosis

Differential diagnosis is performed with other types of burns: alkaline, acidic, thermal, etc. As a rule, in most cases, if the patient is conscious, he can independently name the substance that led to the burn.

Treatment of the hydrogen peroxide burn

The first aid for a burn with a hydrogen peroxide concentrate consists of three steps:

• measures for intensive detoxification;
• detoxication of a chemical;
• symptomatic treatment.

1. The first stage involves extensive washing of the skin or stomach (eye, mouth), depending on where the burn occurred. The probe is washed with vegetable oil before washing the digestive tract.

Also urgent is forced diuresis with alkaline solutions. Suitable is the use of warm teas, compotes, milk, still mineral water. When internal burns are recommended, swallow small pieces of frozen water.

1. In the second stage, when a metabolic acidosis is detected, 4% sodium hydrogencarbonate is injected intravenously into the patient, up to 1.5 l.
2. Symptomatic therapy is the observation of the victim and the appointment of a medication that corresponds to the symptoms.

In cases of burn shock, drop administration of Reopoliglyukin (up to 800 ml), 5% glucose solution (up to 300 ml) is prescribed. In addition, they enter:

• Atropine 0.1% 1 ml SC up to 8 times a day;
• Papaverine 2% 2 ml of penicillin;
• Platifillin 0.2% 1 ml of penicillin.

If the cardiovascular system is inadequate, the following drugs are used:

	Cordiamine	Caffeine
Dosage and Administration	Assign 1-2 ml injection, up to 3 times a day.	The drug is administered subcutaneously for 100-200 mg up to 3 times a day.
Side effects	Nausea, allergies, redness of the upper part of the trunk.	Excitation, increased blood pressure, nausea, arrhythmia.
Special instructions	Not applicable in pregnancy.	Do not use for hypertension, as well as in senile age.

If there is a danger of infection of the burn surface, antibiotic therapy is carried out. The most commonly prescribed antibiotics penicillin series (penicillin up to 8 million units per day).

For external treatment of the wound surface, apply:

	Anestezine	Levomexol
Dosage and Administration	Outer 5-10% ointment. Inside with lesions of the esophagus - 0.3 g to 4 times a day.	The ointment is applied to sterile gauze and applied to the burn site. The dressings are changed daily until the wound is tightened.
Side effects	Allergic manifestations.	Allergy.
Special instructions	There are no restrictions in application.	It is not recommended to use for a long time.

As maintenance treatment, vitamins are prescribed:

• B¹² up to 400 mcg;
• B¹ up to 2 ml of 5% medicament;
• pyridoxine 5% - 2 ml IM.

Vitamins should be administered separately, without mixing in a single syringe.

At puffiness of fabrics of a larynx use aerosol preparations:

• novocaine with ephedrine;
• novocaine with adrenaline.

When the aerosols are ineffective, tracheostomy is performed.

At the healing stage, you can connect physiotherapeutic treatment, which helps alleviate pain, stop the inflammatory process, accelerate tissue repair.

• For anesthesia, transcranial electrostimulation methods are used (Transair, Lanar, El Esculap Medteko).
• For the proper formation of the scab, a special apparatus of Hesk is used.
• For the restoration of tissues at the site of the lesion apply:
  • Khivamat (session 15-20 minutes, treatment - up to 15 sessions);
  • method franklinizatsii (a session of 20 minutes, treatment - up to 30 sessions);
  • ultraviolet irradiation (10 actions every other day);
  • Magnetotherapy (treatment consists of 15 procedures).
• When scarring tissue, these procedures will be relevant:
  • enzymatic electrophoresis with lidase, collagenin, up to 15 procedures;
  • paraffin applications;
  • ultraphonophoresis with hydrocortisone (up to 12 sessions).

Operative treatment can be prescribed urgently with deep burns, both external skin and digestive system. The operation usually has the following objectives:

• restoration of patency of food along the esophagus, restoration of the function of swallowing and breathing, tracheostomy;
• removal of dead tissue, cleaning of wound surface;
• dermoplasty;
• amputation with complete tissue necrosis and the threat of gangrene development.

Operation is a special method of treatment, which is used only in extreme cases.

Alternative treatment of burns with hydrogen peroxide

• Burned skin area of the skin is washed under a stream of water for at least 15 minutes, after which it is treated with a weak solution of baking soda.
• After washing, a tissue moistened with sea buckthorn oil is added to the burned zone with the addition of an oil solution of vitamin E.
• To accelerate the healing it is useful to apply compresses with strong infusion of mother-and-stepmother and oak bark.
• If at hand, there is nothing suitable, then for the compress you can use strong black tea.

With burns of digestive tracts with hydrogen peroxide, the following recipes are used:

• drink a glass of slightly warm milk with two tablespoons of honey;
• to drink freshly prepared starch jelly.

Treatment with herbs can also be used for specific burns of the eyes, oral cavity:

• when the eye is burned, it should be washed with infusion of birch leaves and kidneys (1 tablespoon per 400-500 ml of boiling water);
• apply to the affected eye a compress made of clover color (1 tablespoon per 250 ml of boiling water);
• with a burn of the mouth, rinse with a decoction of chamomile or oak bark (1 tablespoon per 300 ml of boiling water).

[38]

Homeopathy

In recent years, homeopathic medicines have gained increasing confidence in patients and doctors. The effectiveness of such drugs is obvious, and the side effects are minimal. The main thing - just stick to the prescribed dosage.

To treat burns with hydrogen peroxide, you can use such homeopathic medicines.

	Abropernol	Calendula-Salbe-Heel C	Causticum compositum	Camillen-Salbe-Heel C
Dosage and Administration	Take 1 tab. Three times a day.	Apply twice a day under the bandage.	Take 10 drops three times a day.	Twice a day, in the morning and at night, put on the affected place.
Side effects	Rarely - allergies.	Rarely - allergies.	Rarely - allergies.	Rarely - allergies.
Special instructions	You can not - pregnant and lactating women, children.	At the same time, it is recommended to use Traumeel C.	There are no restrictions in application.	Can be used without restrictions.

Prevention

Prevention of burns - is compliance with safety regulations when working with chemicals and concentrated solutions, including with a concentrate of hydrogen peroxide.

• Do not store bubbles and jars that do not have a label or a name for the contents at home.
• Do not stay in contact with the solution for a long time, even if its concentration is considered safe.
• Do not store chemical solutions near storage and cooking.
• The first aid kit and any chemical solutions should be stored in places inaccessible to children and mentally unbalanced members of the family.
• In no case can you pour chemical and medicinal liquids into containers from beverages and foods.
• Bottles with chemicals should be carefully clogged immediately after use.

[39], [40], [41]

Forecast

The prognosis of a burn depends on correctly rendered emergency care. If the concentration of the chemical solution is small, and the rinsing is carried out as quickly and efficiently as possible, the degree of burn will be small. Accordingly, the forecast can be considered favorable.

If the burn with hydrogen peroxide was strong, with a deep tissue damage, the consequences can be extremely negative.

[42]