Lancet: White Phosphorus Burns On An 18-Year Old Civilian Injured During Israeli Attack

Medical News Today - A Case Report in the Lancet details the horrific burns suffered by an 18-year-old male civilian during the Israeli attack on the occupied Palestinian territory during January 2009. The report is by Dr Loai Nabil Al Barqouni, Al Quds University, Abu-Deis, Jerusalem, oPt, and colleagues.

The man presented to the Shifa Medical Centre in the Gaza Strip, oPt, after an attack with an incendiary shell. His wounds covered 30% of his body and were on mainly clustered on his right shoulder and legs. A diagnosis of white phosphorus burn was made, and his wounds were cleaned with diluted sodium bicarbonate solution before wet dressing. However, his alarmed doctors noticed a day later white smoke was coming from the wounds, which contained much dead tissue and has extended deep into the man's flesh. He was urgently transferred to the operating room and had more white phosphorus particles removed; during this process, a particle hit a nurse's neck and left her with a superficial burn.

Eight days later, the man was relatively well, and, 16 months after follow up, has large, tender scars in the areas of his body that were affected. The authors say: "On contact with exposed skin, white phosphorus produces painful chemical burns; these typically appear as yellowish, necrotic, full-thickness lesions due to both chemical and thermal components. Because white phosphorus has high lipid solubility, the injuries often extend deep into underlying tissues with resultant delayed wound healing. White phosphorus can also be absorbed systemically resulting in multiple organ dysfunction syndrome because of its effect on erythrocytes, kidneys, liver, and heart."

They conclude: "We cannot give an estimate of the number of such cases in our burns unit because it is in a war situation in which no formal recording was done; these burns are rarely encountered in practice and literature describing cases is limited. According to the UN Convention on Certain Conventional Weapons it is prohibited to make civilians the object of attack by incendiary weapons."

Link to Lancet - Health in the Occupied Palestinian Territory 2010