Tar burn

Background

• Difficult to remove tar from tissue without solvent
• Tar itself is sterile, but dead tissue underneath is not
• Applies to tar, bitumen, asphalt
• Occupational risk in road workers, roofers, petroleum distillers

Clinical Features

• Tar may be hardened or not yet fully cooled on presentation

Differential Diagnosis

Caustic Burns

• Caustic ingestion
• Caustic eye exposure (Caustic keratoconjunctivitis)
• Caustic dermal burn
• Airbag-related burns
• Hydrofluoric acid
• Tar burn
• Cement burn

Diagnosis

• VBG, CBC, chem, total CK
• CXR
• ECG
• UA (assess for myoglobinuria)
• Serial assessments for compartment syndrome

Management

• Immediately
  • Cool tar with cold water until hardens to limite tissue damage
  • Take care to avoid hypothermia
• Removal
  • Case reports suggest using mild solvents like sunflower oil, butter, or mayonnaise for thin layers
  • Neosporin cream with polysorbate base (not the petroleum base) dissolves tar and may be used for residual tar
  • If thick layer adherent, may use diesel to remove top layers
    • However, such hydrocarbons can be absorbed through burns if in contact with pt
    • Thus, use diesel only for top layer and use other milder solvents for bottom layer

Disposition

• Admit to burn center for >10% TBSA or significant full thickness injury

See Also

• Burns

References

• Karadas S et al. Treatment of tar burns: two case reports. JPMA. August 2014.
• Al-Hoqail R. USE OF DIESEL OIL IN THE REMOVAL OF TAR FROM BITUMEN BURNS. Annals of Burns and Fire Disasters - vol. X - n. 3 - September 1997.