Early definitive treatment of partial-thickness alkali burns with tangential excision and biobrane

Copyright 2018 The Korean Society of Plastic and Reconstructive Surgeons This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copious irrigation, early tangential excision, and dressing are standard treatments for alkali burns [1]. Biobrane is a biosynthetic dressing widely used for partial-thickness burns. However, its use to treat alkali burns has rarely been discussed in the literature. A 34-year-old male suffered a partial-thickness alkali burn caused by accidental paint solvent spillage (Taxite 4000, pH 10) over his face, neck, chest, and hand (11% of total body surface area). Immediate hourly copious irrigation was commenced before a same-day operative scrubdown. After intraoperative irrigation and scrubbing with neutralizing chlorhexidine gluconate 4% liquid soap (pH 5.0–6.5), only the upper limbs were still alkaline (Fig. 1). Hence, we proceeded with ultra-thin tangential excision and debridement over the right upper limb until a litmus test indicated a neutral pH. Biobrane was applied onto the dry clot-free wound bed with sterile Hypafix (Fig. 2). The Biobrane adhered well, was sequentially trimmed, and the wound was exposed by postoperative day 12. The right arm healed by 1 month postoperatively (Fig. 3). Minimal scars were present, only on the medial portion of the right hand, at a 1-year follow-up (Fig. 4). After continuous irrigation, debridement via the