Intravenous calcium gluconate in the treatment of hydrofluoric acid burns

      I would like to raise some concerns regarding the letter to the editor by Isbister (October 2000; article #110019) reporting the failure of intravenous calcium gluconate in the treatment of hydrofluoric acid burns. The concentration of hydrofluoric acid reported was 4%, which in my opinion is too low to elicit symptoms for 5 days. The solution did contain 20% sulfuric acid, which could have resulted in the second-degree burn, and therefore this caused the symptoms mentioned. In addition, I wonder why no local infiltration of calcium gluconate was provided, which may have been better than soaking the hand in the gel of calcium gluconate if in fact the wounds were caused by hydrofluoric acid.
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