{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T23:03:20Z","timestamp":1780441400063,"version":"3.54.1"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Toxicol."],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Severe hydrofluoric acid (HF) burns are life-threatening due to the rapid systemic absorption of fluoride ions, which precipitate profound hypocalcemia and fatal arrhythmias. Traditional conservative neutralization therapies often fail to halt the continuous absorption of toxins from deep necrotic tissues in high-concentration exposures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>\n                      We report a 40-year-old male presenting with severe HF burns (20% total body surface area) following exposure to 40% HF. The patient rapidly developed intractable hypocalcemia (Ca\n                      <jats:sup>2+<\/jats:sup>\n                      0.48\u00a0mmol\/L) and experienced 12 episodes of ventricular fibrillation within 8\u00a0h. Alongside intensive medical resuscitation, an emergency tangential excision of the burn eschar was performed merely 2\u00a0h post-injury to achieve immediate \u201csource control\u201d, synergistically coupled with Negative Pressure Wound Therapy (NPWT). Dynamic urinary fluoride monitoring confirmed a rapid decline in the systemic toxic load following the surgical intervention. The patient survived the critical phase, underwent staged skin grafting, and was discharged with complete clinical recovery and fully preserved physical mobility at the 1-year follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Proactive surgical source control through extremely early tangential excision, combined with NPWT, serves as a novel surgical detoxification strategy that effectively severs the continuous systemic absorption of fluoride. This strategy, validated by dynamic urinary fluoride monitoring, significantly improves survival in severe HF burns and warrants broader clinical adoption.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/ftox.2026.1859979","type":"journal-article","created":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:10:23Z","timestamp":1780438223000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Ultra-early tangential excision combined with negative pressure wound therapy as a novel surgical detoxification strategy for severe hydrofluoric acid burns complicated by intractable hypocalcemia"],"prefix":"10.3389","volume":"8","author":[{"given":"Xiaokun","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Burn, Plastic and Wound Repair, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Burn, Plastic and Wound Repair, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Burn, Plastic and Wound Repair, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chen","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Burn, Plastic and Wound Repair, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Burn, Plastic and Wound Repair, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyan","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Blood Transfusion, The First Hospital of Zibo","place":["Zibo, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"417","DOI":"10.16369\/j.oher.issn.1007-1326.2025.240186","article-title":"Treatment of a case of hypocalcemia due to severe hydrofluoric acid burns with continuous alternative renal therapy","volume":"43","author":"Bai","year":"2025","journal-title":"OccupHealth and Emerg Rescue"},{"key":"B2","doi-asserted-by":"publisher","first-page":"2257","DOI":"10.3889\/oamjms.2018.429","article-title":"Hydrofluoric acid: burns and systemic toxicity, protective measures, immediate and hospital medical treatment","volume":"6","author":"Bajraktarova-Valjakova","year":"2018","journal-title":"Open Access Maced. 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Surg."},{"key":"B11","doi-asserted-by":"publisher","first-page":"E314","DOI":"10.1503\/cmaj.181078","article-title":"Hydrofluoric acid burn","volume":"191","author":"Wang","year":"2019","journal-title":"Cmaj"},{"key":"B12","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1093\/jbcr\/irz136","article-title":"Management of a man with hydrofluoric acid burns: a case report and review","volume":"41","author":"Yu","year":"2020","journal-title":"J. Burn Care Res."},{"key":"B13","doi-asserted-by":"publisher","first-page":"156","DOI":"10.3760\/cma.j.cn501120-20210517-00188","article-title":"Epidemiological characteristics and treatment outcome analysis of 229 patients with hydrofluoric acid burns in hands [Article in Chinese]","volume":"38","author":"Zhang","year":"2022","journal-title":"Chin. J. Burns Wounds"}],"container-title":["Frontiers in Toxicology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/ftox.2026.1859979\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T22:10:26Z","timestamp":1780438226000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/ftox.2026.1859979\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,3]]},"references-count":13,"alternative-id":["10.3389\/ftox.2026.1859979"],"URL":"https:\/\/doi.org\/10.3389\/ftox.2026.1859979","relation":{},"ISSN":["2673-3080"],"issn-type":[{"value":"2673-3080","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,3]]},"article-number":"1859979"}}