Acid attack is defined as the act of throwing acid onto the body of another with the intention to disfigure, torture, or kill. An acid attacker throw acid at their victims, usually at their faces, burning and damaging skin tissue, often exposing and sometimes dissolving the bones.These effects the lives in many more ways then just psychological, social and economical. Burn patients develop a very low self esteem due to pain, social stigma and they lose hope to live.
About 1,500 acid attacks are reported worldwide every year, according to U.K.based charity Acid Survivors Trust International. In India, about 350 cases are legally reported per year, while separate research conducted by an organization Acid Survivors Foundation India, estimated approximately 500–1000 cases per year in India, excluding unreported incidents.This is an alarming situation of increasing incidences where the majority of victims are women (72% )and attacks are often carried out by family members or other related.
Medical and Dental Effects :
The medical effects of acid attacks are extensive. Majority of acid attacks are aimed at the face, and the severity of the damage depends on the concentration of the acid and the time of exposure to the time when it is washed off with a neutralizing agent. Once acid is in contact with skin, acid melts skin tissue and soft tissues exposing the hard tissue or leading to the loss of eyes, ear, nose causing permanent damage.Of these include deformed skull and hair loss, deafness,burned or deformed eyelids, leaving the eyes extremely dry and prone to blindness,shrunken and deformed nose and chin,scarring of the neck. The scars may sometime run downward, welding the chin to the neck or chest.
Mouth becomes shrunken and narrow, and it may lose its full range of motion. Sometimes, the lips may be partly or totally destroyed, exposing the teeth. Eating and speaking can become difficult. Hydrochloric, sulphuric acid, nitric acid are more readily commercially available acids known to cause these deleterious effects. Even in low concentrations soft tissue dissolved in one hour, the teeth became yellow as the acid reaches the tooth, disintegration of apical third of the tooth occurs in 5 hours, and the tooth is shown to be completely dissolved in 8 hours. Sulphuric acid, mostly affects soft tissues while hydrochloric acid dissolves hard tissue more rapidly compared to nitric acid and sulphuric acid.
Restricted airway in acid burn patients is commonly seen if victim inhales acid vapors creating respiratory problems, In addition to these above-mentioned medical effects, acid attack victims face the possibility of septicemia, renal failure, skin pigmentation, and even death.
Infection is a major danger because the dead tissue around deep burns becomes easily infected. Infection may spread to the healthy part of the skin, and may even kill the victim thus the wounds need to be kept clean and long term antibiotics need to be given to fight infection.The urgent reduction of the chemical load on the skin by surgical debridement is considered to limit the damage of these devastating injuries.Post-burn reconstruction is provided based on functional and aesthetic demands. Priority of the reconstructive care is to restore as much as possible the patient to optimum form and function.The conventional treatment consist of immediate and continuous water lavage for 2–3 days, then followed by excision surgery and grafting within one week if necessary.
Scars may also grow over the nostrils or ear canals, and surgery is required to remove them. Custom made splint are used to apply direct pressure over the wound site, preventing the excess formation of collagen fibers and realigns them in a normal pattern minimizing the formation of hypertrophic scars. As the scars thicken and contract, they can cause permanent disability by stiffening temperomandibluar joints and restricting movement leading to difficulty in swallowing.Doctors may need to perform many operations to release the scars and graft new skin over them.Jaw reconstruction and fracture rehablitation may be required in subsequent surgeries to rebuild form and function.Software have been used to employ a 3D motion tracking laser scanner and computer‐aided designing done to provide a custom burn mask to the patient without contacting patient’s skin
Anaplastology is a branch of medicine dealing with the prosthetic rehabilitation of an absent, disfigured, developmental, and acquired defects like: nasal prosthesis, ocular prosthesis, finger prosthesis, calvarian reconstruction. Various alloplastic materials are most commonly used for cranioplastic reconstruction which includes tantalum, titanium, stainless steel(austenite), vitallium. With the evolution of acrylic resins, silicone, and polyethylene, metals have been used less. Heat polymerized polymethyl‑methacrylate and high‑density porous polyethylene (HDPE) which is available in various shapes and forms is found to be an excellent alternative with good flexibility to be molded into desired contours.
Recent advances in maxillofacial dentistry have increased demand for prosthetic rehabilitation of acid attack victims with the team work of oral and maxillofacial surgeons and maxillofacial prosthodontist and ortodontist. Prosthetics are a quick, reversible, and medically uncomplicated procedures with the advantage that the restoration may be readily removed to allow evaluation of the health of underlying tissue. Technological advancement has a profound impact on the maxillofacial restoration of form and function.Patients should be provided good counseling support as the long course of treatment. There are several instances when acid burn patients have bounced back in life. Therefore it is essential for the mental and physical well being of acid attack victim that every effort should be made to restore as much of the facial profile in order to keep their self dignity intact.
GAMEFACE 