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Chemical Ocular Burns: New Understanding and Treatments

Tác giả: Schrage, Norbert; Burgher, Franỗois; Blomet, Jưel; Bodson, Lucien; Gerard, Max; Hall, Alan; Josset, Patrice; Mathieu, Laurence; Merle, Harold

Chủ đề:

Chủ đề: Medicine

Nhà xuất bản: Springer

Năm xuất bản: 2011

Loại tài liệu: Book

Mô tả vật lý: 130 p.

Định danh: 978-3-642-14550-6

Ngôn ngữ: en

Đọc trực tuyến

Tải tài liệu

All aspects of the subject are covered, including history, epidemiology, chemical agents and reactions, histology, pathophysiology, clinical signs, medical and surgical treatments, and emergency care. Particular attention is paid to the mechanisms involved in ocular burns and to the links between the chemical reactivity of corrosive agents and the clinical manifestations. Current principles of decontamination are fully explained and the latest treatment techniques are discussed in detail.

Cover
Title pages
List of Authors
Foreword
Preface
Contents
1: History of Chemical Burns and Relative Treatments
- 1.1 Burns for Doctors in Antiquity
  - 1.1.1 Chemical Burns Since Antiquity
  - 1.1.2 Treatment of Thermal and Chemical Burns in the Second Half of Twentieth Century, the Revolution of Intensive Care
  - 1.1.3 History of the Treatment of Chemical Skin Burns
  - 1.1.4 Conclusion
- 1.2 Modern History of the Chemical Burns
  - 1.2.1 Burns, a Disease of Different Origins
  - 1.2.2 Start of Medical Treatment
  - 1.2.3 Research in Toxicology and Ophthalmology
  - 1.2.4 Rinsing Therapy
  - 1.2.5 Classification of Eye Burns
  - 1.2.6 Specific Treatment Options
  - 1.2.7 Future and Present of Reconstitutive Concepts
- References
2: Epidemiology of Ocular Chemical Burn Injuries
- 2.1 Introduction
- 2.2 Data Limitations and Scope of the Problem
  - 2.2.1 Individual Publications/Case Series
  - 2.2.2 American Association of Poison Centers National Poison Data System (NDPS)
  - 2.2.3 US Bureau of Labor Statistics Data
- 2.3 Etiology
  - 2.3.1 Work-Related Injury
  - 2.3.2 Deliberate Chemical Assault
  - 2.3.3 Complications of Face Peeling
  - 2.3.4 Burn Center/Hospital Studies
- 2.4 Involved Chemicals
- 2.5 Conclusions
- References
3: The Chemical Agents and the Involved Chemical Reactions
- 3.1 From Chemistry to Symptoms
  - 3.1.1 What Is a Chemical Burn?
  - 3.1.2 What Are the Parameters Affecting the Chemical Burn?
  - 3.1.3 Extent of the Matter
- 3.2 The Chemical Agent
  - 3.2.1 Molecular Structure of an Irritant or a Corrosive
  - 3.2.2 Reactive Functional Groups of Irritant or Corrosive Agents
    - 3.2.2.1 Acidic Function
    - 3.2.2.2 Basic Function
      - Energy Scale of AcidBase Reactions: The pK Notion
    - 3.2.2.3 Oxidizing Function
    - 3.2.2.4 Reduction Function
    - 3.2.2.5 Solvent Function
    - 3.2.2.6 Chelating Function or Complexation
      - Energy Scale of Chelation Reactions
    - 3.2.2.7 Alkylation Reaction
      - Reactivity Scale for Alkylating Agents
    - 3.2.2.8 Molecular Reactivity and Chemical Bonds: Main Aspects
  - 3.2.3 Modulation of the Expression of the Reactivity of a Molecule
    - 3.2.3.1 Acetic Acid and Its Derivatives
    - 3.2.3.2 Hydrofluoric Acid
    - 3.2.3.3 Phenol
    - 3.2.3.4 Methylamines Series
    - 3.2.3.5 Last Illustration: Acrolein
  - 3.2.4 Energetic Levels of the Chemical Reactivity
    - 3.2.4.1 Acid–Base Scale
    - 3.2.4.2 Prediction of the Irritant Power of Acids or Bases
    - 3.2.4.3 Scales of Energy Level
- 3.3 Constituents of the Tissues: Which Are the Biological and Biochemical Targets?
- 3.4 The Mechanisms of the Chemical Burn During the Contact Between the Aggressor and the Eye
  - 3.4.1 The Different Elementary Types of Chemical Reactivity
  - 3.4.2 Energy Dimension of Chemical Burns
  - 3.4.3 Key Parameters of Chemical Burns
    - 3.4.3.1 Danger Resulting of the Nature of the Involved Chemical
      - Solid Form
      - Viscosity
      - Exothermic Reaction
        
        Titanium Tetrachloride
        
        Boron Trifluoride
        
        Trichloromethylsilane
        
        Sulfuric Acid
    - 3.4.3.2 Risk Factors in Relation with the Conditions of Use
      - Concentration of the Chemical
      - Phenomenon of the Diffusion of Corrosives in Relation with Their Concentration
      - Time of Contact
      - Temperature
      - Pressure
- 3.5 Practical Conclusions in Order to Manage the Optimal Chemical Decontamination of an Eye
  - 3.5.1 The First Reflex: The Passive Wash Including Dilution and Mechanical Draining
  - 3.5.2 Consequences of a Passive Washing: A Longer Time of Action
  - 3.5.3 The Concept of Active Wash
- 3.6 What is Now the Extent of Our Knowledge About Ocular Chemical Burns?
- References
4: Histology and Physiology of the Cornea
- 4.1 Corneal Functions
- 4.2 Anatomy Reminder
- 4.3 Histology
  - 4.3.1 The Epithelium and Its Basement Membrane
    - 4.3.1.1 The Lacrymal Secretion
    - 4.3.1.2 The Corneal Epithelium
    - 4.3.1.3 The Superficial Cells
    - 4.3.1.4 The Intermediate Cells
    - 4.3.1.5 Basal Cells
    - 4.3.1.6 The Basement Membrane
  - 4.3.2 Bowman’s Membrane
  - 4.3.3 The Stroma
    - 4.3.3.1 Keratocytes
    - 4.3.3.2 The Collagen Lamellae
    - 4.3.3.3 Ground Substance
    - 4.3.3.4 Other Cells
  - 4.3.4 Descemet’s Membrane
  - 4.3.5 The Endothelium
  - 4.3.6 The Limbus
- 4.4 Vascularization
- 4.5 Innervation
- 4.6 Factors of the Corneal Transparency
  - 4.6.1 The Collagen Structure
  - 4.6.2 The Proteoglycans Function
  - 4.6.3 The Absence of Vascularization
  - 4.6.4 The Scarcity of Cells in the Stroma
  - 4.6.5 The Regulation of the Hydration
  - 4.6.6 Mechanism of Recovery of the Corneal Transparency in case of a Burn
    - 4.6.6.1 The Limbus
    - 4.6.6.2 The Stroma
  - 4.6.7 Action of the Intraocular Pressure
- References
5: Physiopathology of the Cornea and Physiopathology of Eye Burns
- 5.1 Physiology of the Cornea
  - 5.1.1 Eye Burns Physiological Barriers
  - 5.1.2 Physiological Mechanisms of Decontamination on the Eye
  - 5.1.3 Physiology of Local Decontamination
  - 5.1.4 Limits of Physiological Decontamination
  - 5.1.5 Limits between Irritation and Burn
  - 5.1.6 Eye Burns
- 5.2 Pathophysiology of Eye Burns1
  - 5.2.1 Types of Burns and Eye Irritation
  - 5.2.2 Mechanisms of Corneal Burns
    - 5.2.2.1 Contact Mechanisms
    - 5.2.2.2 Thermal Contact
      - Cold Gazes
      - Hot Fluids
      - Liquid Metals
      - Particles
      - Steam
    - 5.2.2.3 Eye Burns with Chemically Active Foreign Bodies
    - 5.2.2.4 Eye Burns with Chemically Reactive Fluids
      - Acids
      - Alkali
      - Peroxides
      - Detergents/Solvents
      - Hydrofluoric Acid
  - 5.2.3 Influence of Osmolarity
  - 5.2.4 Penetration Characteristics
  - 5.2.5 Cellular Survival
  - 5.2.6 Release of Inflammatory Mediators
- References
6: Rinsing Therapy of Eye Burns
- 6.1 Important
- 6.2 Mechanisms of Diffusion in Rinsing Therapy
- 6.3 Osmolar Effects in Rinsing Therapy
  - 6.3.1 Types of Irrigation Fluids
- 6.4 Effect of Irrigation Fluids
- 6.5 High End Decontamination
  - 6.5.1 Peroxides and Radicals Decontamination
  - 6.5.2 Hydrofluoric Acid Decontamination
- 6.6 Side Effects of Rinsing Solutions in the Treatment of Eye Burns
- 6.7 Our Expectations
- References
7: The Clinical of Ocular Burns
- 7.1 Few Reminders
  - 7.1.1 Anatomy Reminder
  - 7.1.2 Physiology Reminder
- 7.2 Immediate Clinical of the Ocular Chemical Burn
  - 7.2.1 Initial and Essential Clinical Signs of the Ocular Chemical Burns
    - 7.2.1.1 The Perilimbal (or Conjunctival) Ischemia
    - 7.2.1.2 Ulcer of the Cornea
    - 7.2.1.3 Edema of the Cornea
  - 7.2.2 Roper Hall’s Prognostic Classification of the Chemical Eye Burns
  - 7.2.3 The Initial Sketch
  - 7.2.4 Other Initial Signs of Chemical Eye Burn
    - 7.2.4.1 Signs of Alteration of the Conjunctiva
    - 7.2.4.2 Signs of Intraocular Lesions
    - 7.2.4.3 Extraocular Signs
- 7.3 Clinical Examination of the Evolution of Chemical Eye Burns
  - 7.3.1 Benign Ocular Burns
  - 7.3.2 Serious Ocular Burns
    - 7.3.2.1 Complications on the Ocular Surface
      - Corneal Nonhealing
      - Other Complications on the Ocular Surface
    - 7.3.2.2 Endocular Complication
- Bibliography
8: Surgical Therapeutic of Ocular Burns
- 8.1 Surgical Treatment of Ocular Burns
  - 8.1.1 Debridement/Excision of the Necrotic Tissues
  - 8.1.2 Prevention of the Formation of Symblepharons
  - 8.1.3 Tenon’s Plastics
  - 8.1.4 The Conjunctival Transplantation
  - 8.1.5 Transplantation of Buccal and Nasal Mucosa
  - 8.1.6 The Transplantation of Limbus
    - 8.1.6.1 Exeresis of the Conjunctival Pannus
    - 8.1.6.2 The Limbus Autograft
    - 8.1.6.3 The Limbus Allograft
  - 8.1.7 The Transplantation of Amniotic Membrane
  - 8.1.8 Keratoplasties
    - 8.1.8.1 Big Diameter Transfixion Keratoplasty
    - 8.1.8.2 The Usual Diameter Transfixion Keratoplasty
    - 8.1.8.3 The Deep Lamellar Keratoplasty
    - 8.1.8.4 The Big Diameter Lamellar Keratoplasty
    - 8.1.8.5 The Keratoplasty with Architectonic Goal
  - 8.1.10 Keratoprosthesis
  - 8.1.9 The Transplantation of Cultivated Limbal Epithelial Cells
- 8.2 Surgical Treatment of Eyelid Burns
  - 8.2.1 Surgical Treatment in the Critical Phase
  - 8.2.2 Surgical Treatment in the Sequelar Phase
- 8.3 Conclusion
- References
9: Emergency Treatment
- 9.1 Characteristics and Consequences of Chemical Ocular Traumas
- 9.2 Chemical Emergency: A Race Against the Clock
- 9.3 Stakes in the Management of First Aid
  - 9.3.1 In Occupational Environments
  - 9.3.2 After an Accident on the Public Highway
  - 9.3.3 Industrial Accidents
  - 9.3.4 Attacks
  - 9.3.5 Lack of Initial Care
- 9.4 Organizing the Emergency Chain
- 9.5 Treatment of Ocular Injury: The Importance of the Emergency Chain for Care
  - 9.5.1 Emergency Chain Definition
  - 9.5.2 Safety Obligations
  - 9.5.3 The Specific Management of Chemical Injuries
- 9.6 Which Care Chain for Optimum Management of Chemical Eye Burns?
  - 9.6.1 Immediate Care by “Nonspecialists”
  - 9.6.2 Ophthalmological Management is Often Deferred
  - 9.6.3 Practical Consequences for More Effective Management
    - 9.6.3.1 Develop a Protocol Which Must Be Simple in Every Aspect
    - 9.6.3.2 Training
    - 9.6.3.3 Necessary Specialized Supervision
Index