Sodium Hypochlorite-Induced Upper Extremity Chemical Burns: Case Series of Eight Patients and a Review of the Literature

Sodium hypochlorite (NaClO) is a chemical compound that is widely used in bleaching, stain removal, disinfection, deodorizing and water treatment. Sodium hypochlorite-induced chemical burns have been described and are reported as relatively rare. We report our experience with such cases to illustrate important points regarding management of these burns.
We retrospectively collected the data of NaClO-induced upper extremity chemical burn admissions at a military hospital during an eight-year period (2007 - 2015). Survey data included patient age, gender, burn area, burn depth, treatments and follow-up period.
Eight patients were admitted to our emergency department with complaints of NaClO-induced chemical burns of the upper extremity of skin over an eight-year period. All of the patients were male, with a mean age of 21.25 (19 - 23) years. Four of the burns were diagnosed as second-degree deep dermal chemical burns and the other four were second-degree superficial dermal chemical burns. Two of the patients with second-degree deep dermal chemical burn underwent debridement and skin grafting. All of the patients were then followed for three to nine months.
We recommend the use of tap water for high-volume, long-term lavage. We are against using neutralization chemicals in order to prevent more unforeseeable catastrophic effects, because it is difficult to determine the composition of exposure from NaClO-derived household chemicals. After emergency department evaluation, patients should be hospitalized for at least the first 24 - 48 hours, according to the plastic surgeon’s decision.