Homemade gunpowder injuries are a pain for surgeons

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Gunpowder Gunpowder

Injuries from home-made gunpowder are causing headaches for surgeons, according to the Royal Adelaide Hospital’s Dr Michael Rooke.

Presenting his research to the Royal Australasian College of Surgeons (RACS) Annual Scientific Congress in Adelaide last week, Rooke said his findings were prompted by his own experience treating a young female patient at the RAH after she suffered burns from home-made gunpowder.

He told the congress that, although these types of injuries were rare, when they did occur they were challenging cases for the clinical team to manage.

"The management of any type of gunpowder injury is difficult, but when the gunpowder is home-made we are faced with a more complex scenario," Rooke said.

"Obviously the substance isn’t going to come with a box telling you all of its ingredients. Therefore the clinical team is often in the unenviable position of having to treat the injury without knowing the exact composition of the chemicals that caused it.

"Agents used in the manufacture of these powders are often strong alkalis, necessitating management as both chemical and heat-related injuries," he added.

"Home-made mixtures usually carry impurities due to the manner in which they were developed, which can lead to further injuries."

In the case of the young RAH patient, the initial response was to deliver emergency first aid medical treatment and resuscitation of the patient. The alkali substance of the burn was neutralised, and infected tissue was removed.

Rooke says he and his team followed the RAH Burns Unit Protocol for chemical burns injuries. Once her condition stabilised she was treated with silver dressing (commonly used to treat and prevent wound infection).

A literature review was then performed to determine which chemical compounds the patient may have been exposed to.

Rooke said that although all emergency departments already clinical guidelines for managing burn injuries, he hoped his presentation would provide added insight.

"When we initially treated the patient we didn’t have time to identify the properties of the substance, or to conduct the sort of extensive literature review that we would have liked to," he said.

"Of the recipes identified, the majority consisted of combining an alkaline metal, with an inorganic salt oxidising agent. Such compounds would produce the injuries we observed."

 

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