The Effect of Topical Calcium Gluconate Jelly in Hydrofluoric Acid Burn

Kim, Kea Jeung; Park, Soo Hong

Abstract

BACKGROUND: Calcium gluconate intralesional injection which is widely used as topical treatment of hydrofluoric acid burn gives doctors some inconvenience, since it requires a certain care about the quantity and pressure of infiltration and so on. Therefore we made calcium gluconate jelly, as the suggestion of Kono, for the convenience of topical use.
OBJECTIVE
The purpose of this study was to evaluate the therapeutic effect of calcium gluconate jelly in hydrofluoric acid burn.
METHODS
After carefully shaving off the hair of the back of guinea pigs, each side of the back were burned by three concentrations(5%, 25%, 50% ) of hydrofluoric acid. Left side of guinea pigs back(control group) was treated with saline and hyamine lavage, right side(treated group) was applied with calcium gluconate jelly after hyamine lavage. Then we evaluate the clinical and histologic feature accorriing to each time.
RESULTS
Clinical findings : In 5% hydrofluoric acid burn, both group showed no clinical response until 5 days. In 25% hydrofluoric acid burn, a mild erythema began from 3 hours after exposure in control group, but it began from 12 hours in treated group. In 50% hydrofluoric acid burn, moderate degree skin ulcer developed after 2 days in control group, but it developed after 3 days in treated group. Histopathological findings: In 5% hydrofluoric acid burn, only some inflammatory cell infiltrates in upper dermis were observed in both group after 5 days. In 25% hydrofluoric acid burn, both group showed epidermal cell damage after 6 hours. After 5 days subepidermal bullae and inflammatory cell infiltrates in upper dermis were observed in control group, but only shallow subcorneal bullae and inflammatory cell infiltrates were observed in experimental group. In 50% hydrofluoric acid burn, control group showed epidermal cell damage after 3 hours and subcutaneous fat necrosis were observed after 5 days. But in experimental group epidermal cell damage began after 6 hours, and only subepidermal bullae and inflammatory cell infiltrates in mid dermis were observed after 5 days. Subcutaneous fat necrosis was not observed until 5 days in experimental group.
CONCLUSION
Calcium gluconale jelly and hyamine solution showed the same therapeutic effect in low concentration(5%) hydrofluoric acid burn. But, in mid to high concentration(25%, 50%) hydrofluoric acid burn, topically applied calcium gluconate jelly significantly reduce the tissue damage comparing with hyamie solution. It suggest the therapeutic effect of calcium gluconate jelly in hydrofluoric acid burn treatment is more convenient form.