12 May 2017
The Royal Australasian College of Surgeons (RACS) has today
heard how injuries from home-made gunpowder are presenting an added
conundrum for surgeons in the management of burn injuries.
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Dr Michael Rooke, presented his research to the RACS Annual
Scientific Congress (ASC) today in Adelaide.
His findings were prompted by his own experience treating a young
female patient at the Royal Adelaide Hospital (RAH), after she
suffered burns from home-made gunpowder.
Dr Rooke said that although these types of injuries were rare,
when they did occur they were challenging cases for the clinical
team to manage.
"The management of any type of gun-powder injury is difficult, but
when the gunpowder is home-made we are faced with a more complex
scenario," Dr Rooke said.
"Obviously the substance isn't going to come with a box telling
you all of its ingredients.
"Therefore the clinical team is often in the unenviable position
of having to treat the injury without knowing the exact composition
of the chemicals that caused it.
"Agents used in the manufacture of these powders are often strong
alkalis, necessitating management as both chemical and heat-related
"Home-made mixtures usually carry impurities due to the manner in
which they were developed, which can lead to further injuries," Dr
In the case of the young RAH patient, the initial response was to
deliver emergency first aid medical treatment and resuscitation of
the patient. The alkali substance of the burn was neutralised, and
infected tissue was removed.
Dr Rooke and his team followed the RAH Burns Unit Protocol for
chemical burns injuries. Once her condition stabilised she was
treated with silver dressing (commonly used to treat and prevent
A literature review was then performed to determine which chemical
compounds the patient may have been exposed to.
Dr Rooke said that although all emergency departments already
clinical guidelines for managing burn injuries, he hoped his
presentation would provide added insight.
"When we initially treated the patient we didn't have time to
identify the properties of the substance, or to conduct the sort of
extensive literature review that we would have liked to.
"Of the recipes identified, the majority consisted of combining an
alkaline metal, with an inorganic salt oxidising agent. Such
compounds would produce the injuries we observed.
"By sharing our own experiences we hope to provide guidance to
other medical professionals who may encounter the same sorts of
circumstances that we did."