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Extreme acid burn all over the neck region!

Extreme acid burn all over the neck region!

Who knows if acid or base causes more tissue injury?

A chemical burn occurs when living tissue is exposed to a corrosive substance (such as a strong acid, base or oxidizer) or a cytotoxic agent (such as mustard gas, lewisite or arsine). All may cause extensive tissue damage.

Acids are defined as proton donors (H+), and bases are defined as proton acceptors (OH-). Bases also are known as alkalis. Both acids and bases can be defined as caustics, which cause significant tissue damage on contact. The strength of an acid is defined by how easily it gives up the proton; the strength of a base is determined by how avidly it binds the proton.

Most acids produce coagulation necrosis by denaturing proteins, forming a coagulum (eg, eschar) that limits the penetration of the acid. Bases typically produce a more severe injury known as liquefaction necrosis. This involves denaturing of proteins as well as the saponification of fats, which does not limit tissue penetration. Hydrofluoric acid is somewhat different from other acids in that it produces liquefaction necrosis.

The severity of the burn is related to a number of factors, including the pH of the agent, the concentration of the agent, the length of the contact time, the volume of the offending agent, and the physical form of the agent. The ingestion of solid pellets of alkaline substances results in prolonged contact time in the stomach, thus, more severe burns. In addition, concentrated forms of some acids and bases generate significant heat when diluted or neutralized, resulting in thermal and caustic injury.

The long-term effect of caustic dermal burns is scarring, and, depending on the site of the burn, scarring can be significant.

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