Beware chemical burns from skin preparation solutions

Beware chemical burns from skin preparation solutions

Chlorhexidine is an antibacterial used as an antiseptic and for other applications. It is very difficult to provide a comprehensive list of all preparations that contain chlorhexidine and one medical reference source, Martindale: The Complete Drug Reference, lists over 1000 entries with reference to chlorhexidine. Common examples include :-

  • Antiseptic mouthwashes
  • Antiseptic sore throat lozenges and sprays
  • Antiseptic toothpastes
  • Topical eczema creams
  • Acne creams
  • Antiseptic powders such as athletes foot powder
  • Antiseptic creams
  • Antiseptic wipes
  • Antiseptic dressings
  • Skin washes/cleansers
  • Topical disinfectants
  • Eye drops
  • Contact lens solution
  • Some suncreams

There is some evidence of an increasing number of cases of allergy to chlorhexidine, possibly due to its use in some brands of mouthwash. It is thought that the true incidence of anaphylaxis to chlorhexidine is likely to be underestimated and also that it may be overlooked as the cause of anaphylaxis during surgery where it may also be used.

At present BLB are dealing with a case for a young woman who suffered awful burns to her buttocks whilst in labour with her first child. During the labour the client elected to have an epidural and prior to administering the pain relief her back was cleaned with solvent based chlorhexidine. Unfortunately the excess solution was not wiped away and collected in a dressing the client was sitting on. Several hours later when the client was moved and the dressing taken away it was discovered that she had suffered full thickness skin necrosis. As a consequence the client was unable to enjoy the first few months of her maternity leave and having had a course of injections into the affected areas is now waiting to see a Plastic Surgeon about some revision surgery for her scars.

With the benefit of supportive evidence from an independent Plastic Surgeon and Nursing Expert it is hoped that the NHS Trust concerned will be persuaded to accept liability for its failure to properly protect the integrity of the client’s skin and regularly check for lesions during labour.

For further advice on this subject contact David Gazzard on 01793 615011.

Image by CGP Grey under a Creative Commons Licence