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Wednesday, February 2, 2011

Steam burns to the face, help!!!!!

Dear doctor,

I had burns on my face 5 days back from pressure cooker steam & its contents. I had a blister which got popped while applying water immediately after the accident. Fluid was seen oozing from that spot. Now the skin appears to be a little pink. I wish to ask if that would scar to white. How can I avoid or reduce that?
There are some areas that have become brown on second day. Doctor said I should apply Mupirocin for a week & then continue on Vaseline to keep it moisturized. It seems to be not serious injury. I wish to ask if the pink area would scar.
Please help!
Ruhi Surve.

Dear Ruhi
Thank you very much for your question. I am sorry to hear that you had a steam burn. The normal body temperature is 37 c or 98.4 f. Hence the body can withstand a few degrees more or less. However at temperatures of 40-44 c or 104 to 111.2 f the tissues suffer damage. The cellular proteins denature and even the cellular enzymes and pump mechanisms stop functioning. Over 44 c or 111.2 f it is difficult for the cells to repair this damage. One has to be careful when temperatures cross 40 c as burns can result.

Steam results when water heated to 100 deg c changes to vapour form. However with increased pressures as in a pressure cooker, higher temperatures than 100 deg c can result and therefore steam from a pressure cooker can cause severe burns. Besides this, the steam can be accidently inhaled and result in damage to the lungs, a condition called as inhalation injury. When the face is exposed to the steam, the delicate tissues of the eyes may suffer damage or burns and therefore the eyes need to be examined to make sure they are not damaged in any way.

Cold running water is the best way to treat a burn as soon as it occurs. Hold the burn area under the cold running water till pain subsides for a few minutes (water conducts the heat away from the skin). For big severe burn areas one should be careful and avoid immersing in cold water as this can result in hypothermia (lowering of body temperature) and shock. Application of ice should be avoided for reasons of hypothermia as well as to prevent causing a cold burn (frostbite). For the face one could splash cold water on the face as well as apply cold soaks.

From your history it appears that there was a blister and that the blister broke and released some fluid. This is a sign of a second degree superficial burn. Further it showed an area which is pink and probably blanching, again a sign of a 2nd degree superficial burn. Also you don’t seem to have inhaled the steam or suffered injury to your eyes.

So relax, your burns don’t appear to be serious, and do the following:
You need to clean it with a dilute antiseptic solution or sterile saline thrice a day and apply an antibiotic ointment like Neosporin or fusidic acid ointment. You can also take some pain killers like ibuprofen, paracetamol, diclofenac sodium etc, though in a day or two the pain should reduce considerably. The burn should heal in about two weeks.
Don’t start applying moisturiser cream till the burn is healed totally.
Avoid sunlight as there can be pigmentation and use a sunscreen when you travel outside.
If the pain increases along with redness of normal skin and swelling around the burn, consult your doctor as you may need antibiotics to treat the infection.
Don’t worry about the scars as I feel it is a superficial burn and should heal without scarring by God's grace. You may have some redness or hyperaemia which should go away. Sometimes you may have pigmentation which will need lightening creams.
Please be careful with the pressure cooker as serious burns can result and do read other related articles:
management of 2nd degree superficial burn http://asktheburnsurgeon.blogspot.com/2010/01/management-of-2nd-degree-superficial.html
Burn area estimation
Degree of burns, Avoid burns in kitchen

wishing you a speedy recovery,
With best regards,

Monday, January 31, 2011

Healthcare-Associated Infections (HAIs)

When an individual falls sick and approaches a health care setting, he rarely realises that he may acquire a new illness. Infections or diseases that are transmitted or acquired in a health care setting are referred to as Healthcare-Associated Infections or HAIs. As health care providers we have a responsibility towards our patients and it is imperative that we do not subject the patient to a new infection that could be fatal. Every year, thousands of patients die due to HAIs and millions are spent to tackle this problem.

Kimberly-Clark Health Care has launched a website "Not on My Watch"
(http://www.haiwatch.com/ , http://haiwatchnews.com/ ),  that provides tools and information to help health care professionals and facilities eliminate HAIs. Readers of ‘Asktheburnsurgeon For Free’ should visit this site and gain information and knowledge that will help counter HAIs.

It is time that we seriously dwell on the subject of HAIs, before it is too late. Every centre or health care provider must collect data related to HAIs and send it to a central agency which can put them together, analyse it and suggest ways to counter HAIs. We must avoid the indiscriminate use of antibiotics and focus on ways to prevent cross infection. We must never forget that the enemy consist of billions and billions of bugs and microbes that are perpetually scheming against our patient. If we are able to get together on a global level and fight this menace, I am sure we will be able to control HAIs.