Kirkpatrick and Burd, and Upfal and Doyle have both provided extensive reviews of hydrofluoric acid(HF) burns in the literature. Both describe the patient populations at risk for systemic toxicity as being any burns with >50% concentration, exposure of >5% total body surface area (TBSA) with any HF concentration, and inhalation or ingestion of HF. However, these guidelines have had rare exceptions described in the literature with cases not meeting the above criteria, but systemic toxicity still developing in the setting of other contributing factors such as increased duration of acid exposure. While systemic toxicity occurs commonly with inhalation or ingestion of HF, systemic toxicity does not manifest in minor cutaneous injuries involving low concentrations of HF.

For severe hydrofluoric acid(HF) burns, serum electrolyte levels should be obtained urgently and then frequently monitored as dictated by the degree of clinical exposure and systemic involvement. Guidelines advocate calcium replacement in high-risk groups even before the serum calcium level is determined. The systemic effects are primarily related to electrolyte disturbances – mainly hypocalcemia – but also hypomagnesemia, acidosis, fluorosis and hyperkalemia, which can lead to disturbances of renal, hepatic and cardiac function. Fluoride ions bind calcium and magnesium, and this process may occur at a rate exceeding the body’s ability to mobilize calcium and magnesium in the serum. In the majority of cases, clinical evidence of hypocalcemia is absent; therefore, high-risk patients must be evaluated by electrocardiography for prolonged QT interval and arrhythmias and placed on cardiac monitoring.

Choose the appropriate toe portion Early repair of tissue transplantation finger wound so that it only has a good appearance, but also to restore the original function, to obtain a fine specialist repair. Method: Select the finger portion of hydrofluoric acid burn patients in 7 cases, respectively ipsilateral large A half-toe fibular flap to repair the thumb side Chiban wound three cases, the ipsilateral dorsal big toe nail flap graft distal thumb dorsal wound one case, a second ipsilateral distal finger nail flap repair wounds three cases. flap an area of 0.5 cm × 1.0 cm ~ 1.0 cm × 2.0 cm fit toe. Conclusion: hydrofluoric acid burn wound surgery is an effective method to terminate injury, toenail flap graft finger nails defect is ideal surgical method for less affected by anatomic variations, that does not destroy the well-known area for vessels, surgical trauma, reconstruction in line with the concept of the cycle, to achieve the purpose of the fine of specialist repair.