"Medi-Sol®(formerly De-Solv-it® brand) is far and away the best solvent we've ever used...It removes tar and asphalt from the skin and mucous membranes safely and in half the time that other surface agents take."

YOU NEED a cool head to handle a hot tar injury. The tricky part, according to a group of Utah specialists, is removing the tar safely so you can treat the underlying burn. Partial removal increases the risk of infection, while clumsy removal can easily make the injury much worse.

Proper management of a hot tar or asphalt injury begins at the beginning. "The biggest mistake people make is trying to remove the tar at the scene of the accident," says Dr. Glenn D. Warden, Associate Professor of Surgery at the University of Utah School of Medicine and Director of the Intermountain Burn Center in Salt Lake City. "Tar or asphalt must first be cooled rapidly to room temperature, which takes only a couple of minutes. Immerse the affected area in cold water to dissipate the heat and speed up the hardening process." Prolonged cooling has no benefits, he cautions, and may induce hypothermia, so major injuries must be cooled judiciously. Ideally, of course, the cooling should be done at the scene of the accident. If not, you can do it in the ER when a patient comes in shortly after an accident.

Once cooled, the tar must be removed, but not by manual or mechanical debridement. "Mechanical removal can cause considerable damage, not to mention incredible pain," says Dr. Warden. "Many tar burns are deep second-degree burns with only the hair follicles left to grow new skin. If you pull the tar off, every hair in the area will come off with it."

The best approach is to dissolve the tar. For a time, largely ineffective and occasionally harmful agents such as gasoline and acetone were used as solvents, Dr. Warden and Drs. Robert J. Stratta and Jeffrey R. Saffle and nurse Melva Kravits report in the American Journal of Surgery (vol. 146, p. 766). The next step in discovering a suitable solvent came with the realization that tar is best dissolved by an agent of similar chemical structure such as petroleum. A topical antibiotic in a petroleum or petrolatum base, such as Neosporin ointment, effectively removes tar and asphalt and has the advantage of also fighting infection.

Over the past two and a half years, however, Dr. Warden has come to prefer Medi-Sol®... "Medi-Sol® is far and away the best solvent we've ever used," the Utah expert told EM. "It removes tar and asphalt from the skin and mucous membranes safely and in half the time that other surface agents take. It's nontoxic, nonirritating, and odorless. It also costs far less than other agents. Liberal application and gentle wiping will suffice to remove tar or asphalt from the skin. Eye injuries can be cleared by copiously irrigating the eye with a Medi-Sol® and saline solution."

Once the tar is off, assess and treat the burn as you would any other. The Utah specialists recommend early excision and vigorous physical therapy to minimize disability and get the patient back to his normal routine quickly.

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