Third-degree chemical burns from chlorhexidine local antisepsis.

[a] HemaClear ® , a self-contained, sterile, exsanguinating tourniquet face. Chemical burn was also reported in a 4 year old boy who underwent general anesthesia for elective orchidopexy; within a few hours, the child developed erythema and blistering around the upper buttocks and natal cleft region. The author recommended saline rinsing after antisepsis [4]. In 1995, contact dermatitis involving pru-ritic, burning or painful rashes caused by this antiseptic was reported [5]. No report of a deep burn was found in the literature. In our service, preoperative antisepsis of the skin is performed with chlorhexi-dine soap (Septal Scrub ® , chlorhexidine gluconate 4%, Teva-Israel), which is removed with chlorhexidine alcohol (alcohol chlorhexidine, 0.5% chlorhexidine gluconate in 70% isopropanol). Almost all surgeries involving the extremities in our service are performed with this technique. After this, a single-use tourniquet is applied (HemaClear ™ , self-contained, sterile, exsanguinating tourniquet, OHK Medical Devices, Israel) [Figure A]. Patient descriPtiOn A healthy 55 year old woman was admitted with a displaced ankle fracture to our department for operative treatment. The patient is a nurse in the emergency department in our hospital and is frequently exposed to chlorhexidine solution during the course of her work. No antecedents of drug, food or animal allergic reactions were reported by the patient. The surgery was performed using the chlorhexidine antiseptic technique. Approximately 48 to 72 hours after the operation, redness and pain in the posterior part of the knee was documented. After a week of complaints of mild pain, the patient returned to the outpatient clinic. On examination, a cir-B urns cause coagulative necrosis of the epidermis and underlying tissues. The depth of the injury depends on the temperature to which the skin was exposed and the duration of exposure. Burns are classified into five different causal categories and depths of injury: a) flame, b) hot liquids (scald), c) contact with hot or cold objects, d) chemical exposure, and e) conduction of electricity. Chemicals cause injury by protein destruction, with denaturation, oxidation , formation of protein esters, or tissue desiccation. Irritant contact dermatitis is the most common type of contact dermatitis. It is responsible for approximately 80% of cases of occupational contact dermatitis and is considered the most frequent cause of hand eczema [1]. Skin burn is the most severe complication of irritant contact dermatitis. Chlorhexidine is an effective skin-preparation agent for surgical interventions. Depending on the concentration, chlorhexi-dine has bacteriostatic, …