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• Substances that cause damage on contact with body surfaces
• Degree of injury determined by pH, concentration, volume, duration of contact
• Acidic agents denature proteins via coagulative necrosis
• Alkaline agents may be more dangerous by causing liquefactive necrosis
• Corrosive agents have reducing, oxidising, denaturing or defatting potential

Alkalis

• Hydroxide ion easily penetrates tissue causing immediate cellular destruction
  • May cause deep penetration into surrounding tissues (e.g. abd/mediastinal necrosis)
• Examples
  • Bleach, drain openers, oven cleaners, toilet cleaner, hair relaxers
  • Household bleach rarely causes significant injury

Acids

• Hydrogen ion leads to cell death and eschar formation, which limits deeper involvement
  • However, due to pylorospasm and pooling, high-grade gastric injuries are common
    • Mortality rate is higher compared to strong alkali ingestions
• Ingestion may be complicated by systemic absorption (met acidosis, hemolysis, ARF)
• Examples
  • Auto batteries, drain openers, metal cleaners, swimming pool products, rust remover