Severe burns from alkali drain cleaner

TO THE EDITOR: Alkali drain cleaner has previously been reported to cause oral, oesophageal and cutaneous burns.1-4 The risk of these cleaners causing full thickness cutaneous burns in children needs to be emphasised. Two toddlers recently presented to our hospital with severe burns after exposure to alkali drain cleaning products. An 18-month-old boy opened the box and bit open the silver foil packet of a foaming drain cleaner (Box 1). In addition to oral burns, he was found to have sustained full thickness burns down to subcutaneous fat in both groins and the left thigh (Box 2), with evidence of the cleaner found in his nappy. First aid had not been given. The second patient was a 3-year-old boy who had been playing with the drain cleaner with his siblings. Despite receiving immediate first aid of 30 minutes of cold running water, he sustained full thickness burns in the right groin down to deep fascia. Both patients required surgical debridement and split skin grafting. These two cases highlight the severity of chemical burns that may be caused by a readily available household item. All corrosive chemical products should have clear warning labels with first aid recommendations, be sold exclusively in childproof containers and be stored out of reach at all times. In the event of an injury, clothing should be totally removed, including any nappy, to ensure that all remaining chemical has been removed, and the area irrigated with cold running water for at least 20 minutes.