# Hydrofluoric Acid Cutaneous Burns: A Systematic Review of Emergency Management and General Surgical Sequelae

## TL;DR

This paper reviews how to manage skin burns caused by hydrofluoric acid, focusing on emergency treatment and surgical outcomes.

## Contribution

The study systematically reviews recent HF burn cases to clarify emergency management and surgical outcomes.

## Key findings

- Mild HF exposures were managed with calcium gluconate gel without systemic complications.
- Severe cases led to hypocalcemia, hypomagnesemia, and life-threatening conditions.
- Surgical interventions like debridement and skin grafting were needed for extensive or delayed injuries.

## Abstract

Hydrofluoric acid (HF) is a highly corrosive and toxic chemical capable of causing deep tissue injury and life-threatening systemic electrolyte disturbances. This study systematically reviews reported cases of dermal HF burns over the past decade, with emphasis on immediate management, systemic toxicity, surgical intervention, and clinical outcomes. A systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Thirteen studies comprising individual case reports and one retrospective case series (N=29 patients) were included. HF concentrations ranged from dilute household preparations to highly concentrated industrial exposures, with total body surface area (TBSA) involvement ranging from <5% to 91%. Mild exposures were successfully managed with topical calcium gluconate gel or soaking techniques without significant systemic complications. Severe cases were associated with profound hypocalcemia, hypomagnesemia, hyperkalemia, ventricular dysrhythmias, metabolic acidosis, and shock. Surgical intervention, including debridement and skin grafting, was necessary primarily in patients with extensive or delayed-recognition injuries. Mortality was reported in two cases involving significant TBSA and systemic toxicity. Continued systematic reporting is necessary to refine treatment strategies and improve clinical outcomes.