Highly concentrated solutions of sulfuric acid are available to unclog drains. We have noted a substantial number of both accidental and intentional cutaneous burns caused by these agents.
A retrospective review was conducted of children and adults who sustained sulfuric acid burns over a 13-year period ending in May 1996. Reports of injuries related to drain cleaners filed with the United States Consumer Product Safety Commission between 1991 and 1995 were also reviewed.
Twenty-one patients (13 children, 8 adults) sustained cutaneous burns caused by concentrated sulfuric acid solutions. In 8 instances, the burn was accidental, whereas in 13 cases, sulfuric acid was used as a weapon. Median total body surface area burned was 5% (range, 1-25%). Approximately 50% of burns involved the face and neck. Skin grafting was required in 14 patients (66%). It is estimated that nationwide approximately 3,000 injuries per year are related to drain cleaners and that one-third of these involve cutaneous burns.
Highly concentrated sulfuric acid drain cleaner can produce full-thickness cutaneous burns that require skin grafting in the majority of cases. Proper use of these agents and sequestering them from children may reduce accidental contact; however, their abuse as agents of assault remains a source of significant morbidity.
From the Department of Surgery (G.C.S., S.P.M.), Divisions of Pediatric Surgery (S.J.B., D.B.G.) and Plastic Surgery (M.J.S.), University of Louisville School of Medicine, Louisville, Kentucky.
Address for reprints: Sheldon J. Bond, MD, University of Louisville Department of Surgery, Kosair Children's Hospital, P.O. Box 35070, Louisville, KY 40232-5070.