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

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.