Beware of household remedies. You may get burned!

Abstract

Background: Burns are a common injury presenting with a broad spectrum of severity. The mechanism of burn injuries is generally of a single modality, i.e. thermal, chemical or electrical. Objectives: Herein, we report a case of a burn injury involving, a scald burn injury followed by a superimposed chemical burn injury that aggravated the initial injury and lead to unplanned return to theatre. To our knowledge a unique case like this has not been previously reported in the literature. Case: The patient a fit and healthy 5-year-old male who presented 24 h post-injury to the emergency department. Immediately following the thermal burn injury from hot tea, a slurry of baking soda (sodium bicarbonate) was applied as a first-aid measure and left overnight. The domestic treatment resulted in a full thickness burn of the skin on the chest wall. It is uncommon for scald burns to present acutely with a well demarcated full thickness burn. Presumably, sodium bicarbonate, normally a mild alkali and seemingly innocuous household product, caused additional chemical injury in the setting of partial thickness thermal burn and lead to full thickness skin necrosis after. Furthermore, after debridement to viable tissues, the first attempt at reconstruction with split skin graft was complicated by near total graft failure. We present this case to highlight the danger of domestic treatment with alternative home-made remedies. In addition, we hope that it will provide insight into an unique and rare clinical presentation, as well as provide guidance in the management of such injuries. Keywords: Burns, Burn management, Thermal burns, Chemical burns, Sodium bicarbonate burns, Mixed modality burns, Skin graft in burns