Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium; Ghent Burn Center, C. Heymanslaan 10, 9000 Ghent, Belgium.
Ghent University Hospital, C. Heymanslaan 10, 9000 Ghent, Belgium.
Am J Emerg Med. 2020 Jun;38(6):1199-1202. doi: 10.1016/j.ajem.2020.02.030. Epub 2020 Feb 19.
Since its introduction on the market in 2007, the number of reports on injuries caused by the ignition or explosion of electronic nicotine delivery systems (ENDS) has increased significantly. Two male patients have been treated at our burn center, the for ENDS-related injuries. Their batteries came into contact with metal objects stored in their pants pockets, resulting in a short circuit and finally ignition. In both patients, the combined flame and chemical burn wounds were initially irrigated with water upon arrival at the emergency department, leading to increased levels of pain. In our burn center, the wounds were extensively cleansed which led to a subsequent drop in NRS-scores. Laser Doppler Imaging showed a clear indication for surgery as both patients suffered a partial-thickness burn, with one patient having a patch of full-thickness burn as well. We swiftly performed an enzymatic debridement in both patients, followed by conservative wound management. Although enzymatic debridement is not generally recommended in the treatment of chemical burns, we successfully made use of this treatment option. Different authors advocate the use of mineral oils to irrigate or cover alkali burns, as contact between the chemical compounds and water can set off an exothermic reaction, leading to further injury. We believe that a hypertonic rinsing solution could be recommended as well in an emergency setting and we want to stress the importance of rapid removal of the chemical compounds in suspected chemical burns as well as swift debridement.
自 2007 年上市以来，电子尼古丁传送系统（ENDS）引发的点火或爆炸导致伤害的报告数量显著增加。我们烧伤中心已经治疗了两名与 ENDS 相关损伤的男性患者。他们的电池与存放在裤子口袋中的金属物体接触，导致短路，最终点火。在这两名患者中，火焰和化学烧伤的联合伤在到达急诊部后最初都用清水冲洗，导致疼痛加剧。在我们烧伤中心，对伤口进行了广泛的清洗，这导致 NRS 评分随后下降。激光多普勒成像清楚地表明需要手术，因为两名患者都有部分厚度烧伤，其中一名患者还有一块全厚度烧伤。我们迅速为两名患者进行了酶清创术，然后进行了保守的伤口管理。尽管在化学烧伤的治疗中一般不建议使用酶清创术，但我们成功地使用了这种治疗选择。不同的作者主张使用矿物油冲洗或覆盖碱烧伤，因为化学化合物与水接触会引发放热反应，导致进一步的损伤。我们认为，在紧急情况下也可以推荐使用高渗冲洗溶液，我们要强调在疑似化学烧伤中迅速去除化学化合物以及迅速清创的重要性。
