The depth and severity of chemical burns are related to both the concentration of the agent and the duration of contact with the tissues. These are the only burn injuries which require immediate care of the burn wound. The offending agent must be washed from the body surface as soon as possible. Full thickness, third-degree injury of the skin caused by strong acids may result in tanning or bronzing of the skin which will be waxy, yet pliable to the touch, leading the unwary to underestimate the extent of burn.
Many antipersonnel weapons employed in modern warfare contain white phosphorus.
First aid treatment of casualties with imbedded phosphorus particles consists of copious water lavage and removal of the identifiable particles, following which the involved areas are covered with a saline-soaked dressing and kept moistened until the patient reaches a definitive treatment installation. If transfer will require more than 12 hours, the involved areas should be covered by a liberal application of topical antimicrobial agent to prevent microbial proliferation and the reignition of retained phosphorus particles. This solution combines with the phosphorus on the surface of the particles to form a blue-black cupric phosphide covering which both impedes further oxidation and facilitates the identification of retained particles. If sufficient copper is absorbed through the wound to cause intravascular hemolysis, acute renal failure may result. To avoid this potential complication, copper sulfate solution should never be applied as a wet dressing, and all wounds must be lavaged thoroughly with saline following a copper sulfate rinse to prevent absorption of excessive amounts of copper.