Abstract:
White phosphorus bum is a special subtype of chemical bums, rarely encountered and is very
limited in literature. Case Presentation On January 11, 2009, an 18-year-old male was transferred to
the Emergency room (ER), due to exposure to military attack with White Phosphorus shell, with
multiple scattered patches of full thickness bum, surrounded by sloughed tissue, involving 30% of his
body surface area, distributed in both upper and lower limbs and right shoulder, a clinical diagnosis of
white phosphoms bum was made. Airway was secured, without signs of inhalation bums;
resuscitation fluid was initiated, irrigation with diluted sodium bicarbonate solution and wet dressing
were done. In the Bum Unit, White smoke was noticed coming up from the wounds which became
deeper, with extensive necrotic tissue, apparent localized injuries weren’t correlated with underlying
severe deep destruction. In the operation room, debridement and excision for dead tissues and
removing phosphoms particles was accomplished, transferred to ICU for monitoring of vital signs,
electrolyte disturbance and ECG changes where he was managed accordingly. After 8 days of
hospitalization, the patient was relatively well, and discharged without manifestations of systemic
complication of white phosphoms bum. White phosphoms is transparent combustible substance,
associated with extensive full thickness bum injury with delayed wound healing. In our case, the
management include irrigation by diluted sodium bicarbonate solution at ER, whereas, only water
have been proved to prevent deaths , early excision and massive debridement of particles was
accomplished, electrolyte disturbance was noticed as a complication.
