Long-term Clinical Course of Combined Facial Blast and Chemical Injury Caused by Cyanide Compounds

Blast injuries are complex traumatic events involving multiple mechanisms, including primary injury caused by the blast, secondary injury from flying debris, tertiary injury due to body displacement, and quaternary injury associated with thermal effects, toxic gases, or chemical exposure [1][2][3] . I industrial settings, explosive accidents may also involve hazardous chemicals, which can substantially alter the clinical course and long-term outcomes 4,5) .Cyanide compounds are widely used in industrial processes, such as precious metal extraction and recycling 6,7) .Acute cyanide toxicity is well recognized following inhalation or ingestion.In contrast, cutaneous exposure associated with explosive accidents is exceedingly rare.Furthermore, solutions containing alkaline cyanide can deeply penetrate tissues through saponification of lipids, potentially leading to progressive tissue injury that is not immediately apparent upon initial examination [8][9][10] .Facial blast injuries require prompt assessment of soft tissue damage, facial bone fractures, and ocular involvement.However, in cases involving concomitant chemical exposure, early clinical findings may lead to the underestimation of the extent of tissue injury, resulting in delayed complications and prolonged treatment.Reports describing combined facial blast injuries and chemical burns caused by cyanide compounds are scarce, and long-term outcomes remain poorly documented.