Prolonged intermittent hydrotherapy and early tangential excision in the treatment of an extensive strong alkali burn

It is well known that the first step in the treatment of cutaneous strong alkali burn is very early and persistent washing of the site of injury with large volumes of water. However, ideal duration and the technique of hydrotherapy has not yet been established. Besides hydrotherapy, tangential excision of the injured skin might prevent further tissue damage if it is performed early enough. We report the treatment of a 36-year-old male who sustained 53% body surface area (BSA) cutaneous burn due to caustic soda (NaOH). Prolonged intermittent hydrotherapy, early tangential excision and autografting of the injured skin are the keys for the proper management of extensive strong alkali burn.