Assessing the efficacy and safety of calcium gluconate soaking as a treatment modality for hydrofluoric acid burns

Abstract

Introduction: Hydrofluoric acid is extremely toxic and can corrode tissues while reacting with calcium and magnesium, leading to severe tissue damage. The antidote, calcium gluconate, is effective for treating mild to moderate burns. However, our hospital lacks registered calcium gluconate gel, making treatment challenging. We investigated alternative soaking methods due to scant literature on this approach.

Methods: This retrospective case series study reviews hydrofluoric acid burn cases at China Medical University Hospital from 2004 and 2020, focusing on the effectiveness of calcium gluconate soaking. Among 29 patients treated for hydrofluoric acid burns in our emergency department, treatments included nail removal and debridement, but all received calcium gluconate soaks without requiring calcium injections.

Results: In our emergency department, 29 patients with hydrofluoric acid burns were treated; 8 required hospitalization and one was admitted to the intensive care unit. Burns varied widely in acid concentration (0.03 %-49 %) and size (1.60 ± 2.93 % body surface area). Treatments included nail removal for one patient and debridement for four. All patients underwent calcium gluconate soaking; none received intra-arterial or subcutaneous injections. There were no fatalities or significant electrolyte imbalances.

Discussion: Calcium gluconate soaking is effective for treating mild HF burns in the absence of gel. However, the lack of a control group limits the ability to compare its efficacy to other treatments.

Conclusion: Calcium gluconate soaking may serve as a practical alternative for treating minor HF burns.

Keywords: Calcium gluconate treatment; Electrolyte imbalance; Emergency medicine; Hydrofluoric acid burns; Treatment efficacy.