A Case of Abdominal Wall Burn Caused by Subcutaneously Embedded Molten Aluminum

Abstract

In the case of abdominal injury, the extent of damage should be assessed prior to reconstruction. Herein, we report a rare case of abdominal wall burns with molten aluminum. A 70-year-old man was admitted to the emergency department. Melted aluminum blew during die casting and fell on the patient while he was working at an aluminum-refining plant. When he arrived at our hospital, metal particles were embedded in his lower left abdomen. We urgently removed the aluminum particles and debrided the surrounding tissue on the day of admission. From the 4th to 31st day after the injury, negative pressure wound therapy with instillation and dwell time was performed for wound management. After therapy, the wound was covered with sufficient granulation tissue. We decided not to reconstruct the components to strengthen the abdominal wall, and the wound was closed using a split-thickness skin graft. We report this rare case along with a review of the literature.

Photos and images on the day of admission.

(a) Photograph of the wound immediately after the patient arrived at the hospital. The large mass in the center and the small mass scattered around it are aluminum clumps. (b) Radiographic image before surgery. Abdominal radiography revealed a high absorption area in the left abdomen. (c) Computed tomography image (coronal) before surgery. A mass with high absorption is observed in the left abdominal wall. We assumed that the external oblique, inner abdominal oblique, and lumbar quadrate muscles were damaged. (d) Intraoperative photographs of debridement on the day of injury. Clumps of aluminum cooled and solidified in the belly. As much necrotic tissue as possible was removed. (e) Intraoperative photographs of debridement on the day of injury. After debridement, a small defect was observed in the transverse abdominal muscle (arrow).