Diphoterine for Chemical Burns of the Skin: A Systematic Review

The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical splashes. In this systematic review, we aimed to assess the effect of diphoterine on chemical burns compared with water or no treatment. The...

Full description

Saved in:
Bibliographic Details
Published inEuropean burn journal Vol. 4; no. 1; pp. 55 - 68
Main Authors Dinesen, Felicia, Pape, Pernille, Vestergaard, Martin Risom, Rasmussen, Lars Simon
Format Journal Article
LanguageEnglish
Published MDPI AG 01.03.2023
Subjects
Online AccessGet full text

Cover

Loading…
Abstract The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical splashes. In this systematic review, we aimed to assess the effect of diphoterine on chemical burns compared with water or no treatment. The primary endpoint was the depth of burn, and secondary outcomes included pain, duration of hospitalization, time to return to work, need for surgery, pH, and complications. PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar were systematically searched using the terms “Diphoterine”, “Previn”, and ““Amphoteric solution” AND “burn””. A total of nine studies were included. One study evaluated the depth of chemical burns and found no difference between the diphoterine group and the control group. Four studies reported on pain, three of which found a more pronounced decrease in pain when using diphoterine compared to the control groups. Two studies found a significant neutralization of pH when using diphoterine. No differences were found for the remaining endpoints. Based on the very low certainty of evidence, this systematic review reports no observed difference between diphoterine and water or no treatment on the depth of a chemical burn. Diphoterine appeared to be associated with less pain and to have a neutralizing effect.
AbstractList The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical splashes. In this systematic review, we aimed to assess the effect of diphoterine on chemical burns compared with water or no treatment. The primary endpoint was the depth of burn, and secondary outcomes included pain, duration of hospitalization, time to return to work, need for surgery, pH, and complications. PubMed, Embase, Cochrane Library, Web of Science, and Google Scholar were systematically searched using the terms “Diphoterine”, “Previn”, and ““Amphoteric solution” AND “burn””. A total of nine studies were included. One study evaluated the depth of chemical burns and found no difference between the diphoterine group and the control group. Four studies reported on pain, three of which found a more pronounced decrease in pain when using diphoterine compared to the control groups. Two studies found a significant neutralization of pH when using diphoterine. No differences were found for the remaining endpoints. Based on the very low certainty of evidence, this systematic review reports no observed difference between diphoterine and water or no treatment on the depth of a chemical burn. Diphoterine appeared to be associated with less pain and to have a neutralizing effect.
Author Dinesen, Felicia
Pape, Pernille
Vestergaard, Martin Risom
Rasmussen, Lars Simon
Author_xml – sequence: 1
  givenname: Felicia
  orcidid: 0000-0002-2462-7049
  surname: Dinesen
  fullname: Dinesen, Felicia
– sequence: 2
  givenname: Pernille
  orcidid: 0000-0001-6289-6277
  surname: Pape
  fullname: Pape, Pernille
– sequence: 3
  givenname: Martin Risom
  surname: Vestergaard
  fullname: Vestergaard, Martin Risom
– sequence: 4
  givenname: Lars Simon
  orcidid: 0000-0002-7480-3004
  surname: Rasmussen
  fullname: Rasmussen, Lars Simon
BookMark eNpNkEtLAzEUhYMoWGs3_oKshdE8ZpKJG6n1VSgIVtdDkrnXpraTkhmV_ntHK-rqHs45fFzOEdlvYgOEnHB2JqVh5-CWOeOMMbVHBkJpmXFj-P4_fUhGbbvsG6LUvacG5PI6bBaxgxQaoBgTnSxgHbxd0au31LQ0Iu0WQOevobmgYzrfth2sbRc8fYT3AB_H5ADtqoXRzx2S59ubp8l9Nnu4m07Gs8wLJbtM-sKAdd5hXSrm0QqWO88k5i5H3ofCFFzXtnYCtcp9KQpQQuuSaWsASzkk0x23jnZZbVJY27Stog3VtxHTS2VT_9YKKhQKnMGydoXOc8kcMmNrw1CWVqPlPet0x_Iptm0C_OVxVn0tWf0tKT8BexxnLA
CitedBy_id crossref_primary_10_3390_ebj4030026
crossref_primary_10_3390_ebj4020023
Cites_doi 10.1136/bmj.n71
10.1080/15569520601013160
10.1111/iwj.13193
10.1111/j.1365-4632.2009.04397.x
10.1080/15569527.2016.1217423
10.1016/j.burns.2017.09.017
10.1186/s40360-020-00465-8
10.1016/j.burnso.2018.03.001
10.11613/BM.2012.031
10.1016/j.bjps.2017.02.013
10.1080/15569520600695520
10.1016/j.burns.2011.09.014
10.1136/bmj.b2535
10.1177/0960327115578866
10.1016/j.legalmed.2009.01.008
10.3109/15569520903269122
ContentType Journal Article
DBID AAYXX
CITATION
DOA
DOI 10.3390/ebj4010006
DatabaseName CrossRef
Directory of Open Access Journals
DatabaseTitle CrossRef
DatabaseTitleList
CrossRef
Database_xml – sequence: 1
  dbid: DOA
  name: Directory of Open Access Journals
  url: https://www.doaj.org/
  sourceTypes: Open Website
DeliveryMethod fulltext_linktorsrc
EISSN 2673-1991
EndPage 68
ExternalDocumentID oai_doaj_org_article_f26eb9f8db574430bf09ad90f38a7fa1
10_3390_ebj4010006
GroupedDBID AAYXX
AFZYC
ALMA_UNASSIGNED_HOLDINGS
CITATION
GROUPED_DOAJ
MODMG
M~E
ID FETCH-LOGICAL-c263t-3c59eabcbfd860cfa204bc03f4b4f1c5929517dadb2f764c825e6277807a9ef83
IEDL.DBID DOA
ISSN 2673-1991
IngestDate Thu Jul 04 21:08:50 EDT 2024
Fri Aug 23 03:25:49 EDT 2024
IsDoiOpenAccess true
IsOpenAccess true
IsPeerReviewed true
IsScholarly true
Issue 1
Language English
LinkModel DirectLink
MergedId FETCHMERGED-LOGICAL-c263t-3c59eabcbfd860cfa204bc03f4b4f1c5929517dadb2f764c825e6277807a9ef83
ORCID 0000-0002-7480-3004
0000-0001-6289-6277
0000-0002-2462-7049
OpenAccessLink https://doaj.org/article/f26eb9f8db574430bf09ad90f38a7fa1
PageCount 14
ParticipantIDs doaj_primary_oai_doaj_org_article_f26eb9f8db574430bf09ad90f38a7fa1
crossref_primary_10_3390_ebj4010006
PublicationCentury 2000
PublicationDate 2023-03-01
PublicationDateYYYYMMDD 2023-03-01
PublicationDate_xml – month: 03
  year: 2023
  text: 2023-03-01
  day: 01
PublicationDecade 2020
PublicationTitle European burn journal
PublicationYear 2023
Publisher MDPI AG
Publisher_xml – name: MDPI AG
References Alexander (ref_7) 2018; 44
Brvar (ref_13) 2016; 35
Lewis (ref_20) 2017; 70
Page (ref_23) 2021; 372
Ahmad (ref_16) 2015; 28
Kozawa (ref_4) 2009; 11
ref_12
Cartotto (ref_5) 1996; 39
Amigo (ref_14) 2012; 24
ref_10
Hardwicke (ref_1) 2012; 38
Donoghue (ref_17) 2010; 49
Akelma (ref_3) 2019; 16
Cavallini (ref_18) 2010; 6
Hall (ref_21) 2009; 28
McHugh (ref_11) 2012; 22
ref_2
ref_15
Lynn (ref_22) 2017; 36
Moher (ref_9) 2009; 339
Nehles (ref_19) 2006; 25
Kulkarni (ref_8) 2018; 2
Hall (ref_6) 2006; 25
References_xml – volume: 372
  start-page: n71
  year: 2021
  ident: ref_23
  article-title: The PRISMA 2020 statement: An updated guideline for reporting systematic reviews
  publication-title: BMJ
  doi: 10.1136/bmj.n71
  contributor:
    fullname: Page
– volume: 25
  start-page: 249
  year: 2006
  ident: ref_19
  article-title: Diphoterine for emergent decontamination of skin/eye chemical splashes: 24 cases
  publication-title: Cutan. Ocul. Toxicol.
  doi: 10.1080/15569520601013160
  contributor:
    fullname: Nehles
– ident: ref_2
– volume: 16
  start-page: 1330
  year: 2019
  ident: ref_3
  article-title: Rare chemical burns: Review of the Literature
  publication-title: Int. Wound J.
  doi: 10.1111/iwj.13193
  contributor:
    fullname: Akelma
– volume: 49
  start-page: 894
  year: 2010
  ident: ref_17
  article-title: Diphoterine for alkali chemical splashes to the skin at alumina refineries
  publication-title: Int. J. Dermatol.
  doi: 10.1111/j.1365-4632.2009.04397.x
  contributor:
    fullname: Donoghue
– ident: ref_10
– volume: 39
  start-page: 205
  year: 1996
  ident: ref_5
  article-title: Chemical burns
  publication-title: Can. J. Surg.
  contributor:
    fullname: Cartotto
– volume: 36
  start-page: 185
  year: 2017
  ident: ref_22
  article-title: The safety and efficacy of Diphoterine for ocular and cutaneous burns in humans
  publication-title: Cutan. Ocul. Toxicol.
  doi: 10.1080/15569527.2016.1217423
  contributor:
    fullname: Lynn
– volume: 44
  start-page: 752
  year: 2018
  ident: ref_7
  article-title: Chemical burns: Diphoterine untangled
  publication-title: Burns
  doi: 10.1016/j.burns.2017.09.017
  contributor:
    fullname: Alexander
– ident: ref_12
  doi: 10.1186/s40360-020-00465-8
– volume: 2
  start-page: 104
  year: 2018
  ident: ref_8
  article-title: The effects of the use of Diphoterine® solution on chemical burns in the Tarapur industrial complex, India
  publication-title: Burns Open
  doi: 10.1016/j.burnso.2018.03.001
  contributor:
    fullname: Kulkarni
– volume: 22
  start-page: 276
  year: 2012
  ident: ref_11
  article-title: Interrater reliability: The kappa statistic
  publication-title: Biochem. Med.
  doi: 10.11613/BM.2012.031
  contributor:
    fullname: McHugh
– ident: ref_15
– volume: 6
  start-page: 145
  year: 2010
  ident: ref_18
  article-title: Evaluation of cutaneous pH after chemical peel and its correction with amphoteric solutions
  publication-title: J. Plast Dermatol.
  contributor:
    fullname: Cavallini
– volume: 70
  start-page: 563
  year: 2017
  ident: ref_20
  article-title: Is it time for a change in the approach to chemical burns? The role of Diphoterine® in the management of cutaneous and ocular chemical injuries
  publication-title: J. Plast Reconstr. Aesthet. Surg.
  doi: 10.1016/j.bjps.2017.02.013
  contributor:
    fullname: Lewis
– volume: 25
  start-page: 67
  year: 2006
  ident: ref_6
  article-title: Water decontamination of chemical skin/eye splashes: A critical review
  publication-title: Cutan. Ocul. Toxicol.
  doi: 10.1080/15569520600695520
  contributor:
    fullname: Hall
– volume: 38
  start-page: 83
  year: 2012
  ident: ref_1
  article-title: Chemical burns—An historical comparison and review of the literature
  publication-title: Burns
  doi: 10.1016/j.burns.2011.09.014
  contributor:
    fullname: Hardwicke
– volume: 339
  start-page: 2535
  year: 2009
  ident: ref_9
  article-title: Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement
  publication-title: BMJ
  doi: 10.1136/bmj.b2535
  contributor:
    fullname: Moher
– volume: 35
  start-page: 213
  year: 2016
  ident: ref_13
  article-title: Chlorobenzylidene malononitrile tear gas exposure: Rinsing with amphoteric, hypertonic, and chelating solution
  publication-title: Hum. Exp. Toxicol.
  doi: 10.1177/0960327115578866
  contributor:
    fullname: Brvar
– volume: 24
  start-page: 3
  year: 2012
  ident: ref_14
  article-title: Chemical decontamination in the emergency
  publication-title: Emergencias
  contributor:
    fullname: Amigo
– volume: 28
  start-page: 9
  year: 2015
  ident: ref_16
  article-title: The clinical efficacy of Diphoterine® in the management of cutaneous chemical burns: A 2-year evaluation study
  publication-title: Ann. Burn. Fire Disasters
  contributor:
    fullname: Ahmad
– volume: 11
  start-page: 535
  year: 2009
  ident: ref_4
  article-title: An autopsy case of chemical burns by hydrochloric acid
  publication-title: Legal Med.
  doi: 10.1016/j.legalmed.2009.01.008
  contributor:
    fullname: Kozawa
– volume: 28
  start-page: 149
  year: 2009
  ident: ref_21
  article-title: Safety of dermal diphoterine application: An active decontamination solution for chemical splash injuries
  publication-title: Cutan. Ocul. Toxicol.
  doi: 10.3109/15569520903269122
  contributor:
    fullname: Hall
SSID ssj0002876736
Score 2.287834
Snippet The incidence of chemical burns appears to be increasing. Diphoterine is an amphoteric, chelating, polyvalent solution used for the decontamination of chemical...
SourceID doaj
crossref
SourceType Open Website
Aggregation Database
StartPage 55
SubjectTerms chemical burn
chemical splash
skin burns
Title Diphoterine for Chemical Burns of the Skin: A Systematic Review
URI https://doaj.org/article/f26eb9f8db574430bf09ad90f38a7fa1
Volume 4
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV09T8MwELVQJxYEAkT5kiVYozr-TFhQC1QVUlmgUrfI59iCDm0FYeW3c47bUiYWlgyJFSXvJN971t07Qq4xB_kiaJ7x2CEjDdcZKK8zzZyXijupdewdHj_p0UQ-TtV0a9RXrAlL9sAJuF7g2kMZihqUkVIwCKy0dcmCKKwJNgmfXG2JqVl7ZGRiwVLyIxWo63seZigl4u78KwNtGfW3GWW4T_ZWVJD20ycckB0_PyS392_L10XTNuVRJJR03dFPB7j8gy4CRcpG48ysG9qnzxsjZppO-Y_IZPjwcjfKVkMOMse1aDLhVOktOAh1gQAFy5kEx0SQIEOODzlyIFPbGngwWjpUdF5zYwpmbOlDIY5JZ76Y-xNCwSvrJM-t1ZiXo7bN6xKMZSCsEarukqv1j1fL5GVRoQaI8FQ_8HTJIGKyWRH9p9sbGJVqFZXqr6ic_sdLzshuHO6eKr7OSad5__QXSAEauGyjjdfx18M31qewUA
link.rule.ids 315,786,790,870,2115,27955,27956
linkProvider Directory of Open Access Journals
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Diphoterine+for+Chemical+Burns+of+the+Skin%3A+A+Systematic+Review&rft.jtitle=European+burn+journal&rft.au=Dinesen%2C+Felicia&rft.au=Pape%2C+Pernille&rft.au=Vestergaard%2C+Martin+Risom&rft.au=Rasmussen%2C+Lars+Simon&rft.date=2023-03-01&rft.issn=2673-1991&rft.eissn=2673-1991&rft.volume=4&rft.issue=1&rft.spage=55&rft.epage=68&rft_id=info:doi/10.3390%2Febj4010006&rft.externalDBID=n%2Fa&rft.externalDocID=10_3390_ebj4010006
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=2673-1991&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=2673-1991&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=2673-1991&client=summon