手術中普威隆碘酒液引起化學灼傷－－病例報告

Chemical Burn Caused by Providone-iodine Alcohol Solution-- A Case Report

因用消毒液造成皮膚灼傷的情形非常少見，造成這些病人皮膚傷害的原因常常與皮膚受到外界的刺激、局部受到壓力並合併受到消毒液體的浸軟有關。我們在此報告一位24歲患有甲狀腺腫瘤女性病人，入院接受次全甲狀腺切除手術。病患在全身插管麻醉後，接受常用10％濃度的普威隆碘酒液消毒，消毒及手術時姿勢，為保持平躺、上半身高20度姿勢。病患從手術開始至手術結束送出，約歷時3小時45分。病患在送至恢復室後，除抱怨手術傷口疼痛外，更抱怨背部燒灼痛；後發現病患背部有一處約9x11平方公分深褐色的紅腫區域。後經診察為一淺二度的化學灼傷並立刻接受燒傷藥膏包紮處理。病人在經過四天術後住院治療及三週門診換藥後，背部灼傷痊癒。我們提出此一病例，以供預防參考及討論。

Burns associated with chemical disinfectants for skin preparation are rare. Skin irritation and maceration associated with pressure factors may contribute to its occurrence. We report a 24-year-old female with thyroid tumor who was admitted for subtotal thyroidectomy. After anesthetic induction, the patient was placed in the supine position with the trunk elevated to 20 degree. The skin over the anterior neck was sterilized with 10% Povidoneiodine (PI) alcohol solution. After a 3-hour surgery, the patient complained of burning pain over the back at the recovery room. Physical examination revealed a 9x11 cm area of skin lesion partially thickened amid on the middle of the back suggestive of chemical burn. After conservative treatment, she was discharged uneventfully 4 days later. Upon follow-up, the wound was seen to heal with minimal scarring within 3 weeks.