Hickey Sean, Goverman Jeremy, Friedstat Jonathan, Sheridan Robert, Schulz John
Massachusetts General Hospital, Department of Surgery, Sumner Redstone Burn Center, United States.
Massachusetts General Hospital, Department of Surgery, Sumner Redstone Burn Center, United States.
Burns. 2018 Aug;44(5):1294-1301. doi: 10.1016/j.burns.2018.02.008. Epub 2018 Mar 2.
There are an estimated 2.75 million electronic cigarette (EC) users in the United States. ECs have become the most commonly used nicotine-containing product in young adults ages 18-24 years. Thermal, blast, and missile injuries from EC explosions has grown rapidly in recent years. Burn surgeons must remain up to date regarding management and treatment of burn injuries related to EC device ignition.
An IRB approved retrospective review of all patients admitted to the Massachusetts General Hospital Burn Center from January 2015 to April 2017 was performed. Fourteen patients with injuries associated with EC use were identified. Patient demographics, injury location, size and degree of burn, treatments required, length of stay (LOS), time to 95% closure, associated complications and injuries, and the circumstances that led to the injury were identified.
The mean age was 28.6±8.6 years with a range of 19-50 years (n=14). EC burns occurred in males 93% (13/14) of the time. The majority of EC explosions caused 2nd and 3rd degree burns (57%) within the same wound bed, followed by deep 2nd degree (29%), and superficial 2nd degree (14%). The average TBSA from EC burns was 4.7±2.4% with a range of 1-10%. The most common location of the device or battery at the time of the injury was a pant pocket 86% (12/14), followed by 7% hand (1/14) and 7% purse (1/14). Isolated lower extremity burns occurred in 43% (6/14) of patients, while lower extremity and hand burns occurred in 21% (3/14) of patients. Nine of 14 patients required an operating room encounter under general anesthesia. Eight of 14 patients required skin grafting for definitive wound closure. The mean hospital length of stay was 6.6±4.7 days with a range of 0-15 days. Time to 95% wound closure was 18.4±10.8 with a range of 8-40 days.
Thermal and blast injuries associated with EC device failure tend to cause small TBSA burns that are deep 2nd and 3rd degree wounds. The most common location for EC device storage among males was the front pants pocket. EC device users should be made aware of the dangers associated with EC use and advised to carry EC devices away from their body in dedicated carrying cases without loose metallic items.
据估计，美国有275万电子烟使用者。电子烟已成为18至24岁年轻成年人中最常用的含尼古丁产品。近年来，电子烟爆炸造成的热烧伤、爆炸伤和弹片伤迅速增加。烧伤外科医生必须及时了解与电子烟设备起火相关的烧伤管理和治疗方法。
对2015年1月至2017年4月入住马萨诸塞州总医院烧伤中心的所有患者进行了一项经机构审查委员会批准的回顾性研究。确定了14例与使用电子烟相关的受伤患者。确定了患者的人口统计学特征、受伤部位、烧伤面积和程度、所需治疗、住院时间、伤口95%闭合时间、相关并发症和损伤以及导致受伤的情况。
平均年龄为28.6±8.6岁，范围为19至50岁（n = 14）。93%（13/14）的电子烟烧伤发生在男性身上。大多数电子烟爆炸在同一伤口床内造成二度和三度烧伤（57%），其次是深二度烧伤（29%）和浅二度烧伤（14%）。电子烟烧伤的平均体表面积为4.7±2.4%，范围为1%至10%。受伤时设备或电池最常见的位置是裤兜，占86%（12/14），其次是手部占7%（1/14）和钱包占7%（1/14）。43%（6/14）的患者仅下肢烧伤，2l%（3/14）的患者下肢和手部烧伤。14例患者中有9例需要在全身麻醉下进行手术室治疗。14例患者中有8例需要植皮以实现伤口的最终闭合。平均住院时间为6.6±4.7天，范围为0至15天。伤口95%闭合的时间为18.4±10.8天，范围为8至40天。
与电子烟设备故障相关的热烧伤和爆炸伤往往导致体表面积较小的烧伤，为深二度和三度伤口。男性中电子烟设备最常见的存放位置是前裤兜。应让电子烟设备使用者了解与使用电子烟相关的危险，并建议他们将电子烟设备放在专用携带盒中，远离身体，且盒内不要有松散的金属物品。
