Background Devices containing lithium-ion batteries are increasingly used in direct contact with the skin due to the rise in wearable electronics. Burns associated with lithium-ion batteries are typically reported following battery failure with combustion, explosion or chemical leakage. We report an unusual full-thickness contact burn caused by a smart watch in the absence of overt device failure. Case presentation A 48-year-old woman sustained a thermal injury to the left dorsal wrist while wearing a waterproof smart watch during a shower. The watch demonstrated no visible external damage, combustion, smoke, venting or explosion. The injury was initially managed in primary care and remained unhealed at 14 days. At day 28, assessment at a tertiary burns service demonstrated a 0.1% total body surface area (TBSA) full-thickness burn. The wound underwent excision and split-thickness skin grafting under local anaesthesia in the outpatient burns clinic. The graft demonstrated satisfactory early take and the patient subsequently achieved uncomplicated wound healing. Conclusion This case demonstrates that smartwatches containing lithium-ion batteries may cause a full-thickness thermal contact burn without the clinical features traditionally associated with catastrophic battery failure. The absence of visible device damage or overt thermal runaway should not exclude the possibility of a deep thermal injury. Early assessment of burn depth and timely referral to specialist burns services remain important for even seemingly minor burns caused by wearable electronic devices.
Background Severe burn injuries are commonly complicated by high rates of infection and antimicrobial resistance (AMR). Longitudinal data mapping microbial dynamics in burn patients, particularly following mass casualty events, are limited. The study aimed to analyzing the microbial trends and AMR patterns derived from weekly paired blood and wound specimens collected from survivors of the Morogoro disaster. Methodology A retrospective longitudinal observation study was conducted on 13 critically ill burn patients from the 2019 disaster of a fuel tanker exploded in Morogoro, Tanzania. Weekly paired blood and deep wound swabs were collected, yielding 90 specimens over 12 weeks. Isolated bacteria were identified and tested for antibiotic susceptibility. Results A total of 62 pathogenic isolates were recovered. A clear temporal shift was observed: initial dominance by multidrug-resistant (MDR) gram-negative pathogens (Acinetobacter baumannii, Pseudomonas aeruginosa) in Weeks 1–2, followed by a transition to gram-positive bacteria (Weeks 3–5), and finally a resolution phase (Weeks 6–12) characterized by sterile cultures. Resistance escalated rapidly; in A. baumannii, resistance to third-generation cephalosporins rose to 71.4% by Week 2. Concordance between blood and wound isolates confirmed the burn wound as the source of invasive infection. Mortality was 76.9%, with all fatalities attributed to sepsis. Conclusion Serial surveillance reveals a predictable microbial succession and alarming acceleration of AMR in severely burned patients, directly linking wound colonization to lethal sepsis. These findings underscore the urgent need for protocolized serial culture-guided antibiotic stewardship and reinforced infection control in burn management.
Background Severe burn injuries commonly lead to organ dysfunction and death, especially in low- and middle-income countries. Early identification of risk factors can improve outcomes. This study determined the incidence, pattern, and predictors of organ dysfunction and mortality among adults with severe burn injuries admitted to a tertiary burn centre in Ghana. Methods A prospective study was conducted at the National Reconstructive Plastic Surgery and Burns Centre, Korle-Bu Teaching Hospital, from April 2022 to December 2023. Adults aged 18–60 years with severe burns (≥20–70% TBSA) presenting within 48 h were enrolled. Data on demographics, burn severity, duration before presentation, cause, organ dysfunction, and mortality were gathered. Organ dysfunction was defined using clinical and biochemical criteria. Associations were assessed using Fisher's exact test and logistic regression, with statistical significance set at p < 0.05. Results Forty-two participants were included. The male-to-female ratio was 1.3:1. The median TBSA was 38%. Flame burns caused 85.7% of injuries. Organ dysfunction developed in 54.8% of participants, with renal dysfunction most common (45.2%). Presentation after 7 h independently increased the odds of organ dysfunction (OR = 5.73; p = 0.017). The mortality rate of 38.1% was significantly associated with ≥30% TBSA burns (p = 0.001) and higher weight categories (p = 0.014). Conclusion Severe burns were associated with high organ dysfunction and mortality. Renal dysfunction was most common. Delayed presentation significantly increased the risk of organ dysfunction. Larger TBSA burns were strongly linked to mortality. Early presentation and prompt management may improve outcomes.
White phosphorus (WP) causes simultaneous thermal burns, inhalational toxicity, and long-term rehabilitation needs, making it an inherently multidisciplinary hazard that is particularly consequential for children. This study develops a focused quantitative-descriptive framework, centered on a paediatric population in the occupied Palestinian territory, that operationalizes a selected subset of governing thermophysical equations under explicit boundary conditions, links the outputs to biomedical benchmarks, and triangulates both against a translated 100-response local questionnaire completed by caregivers reporting on children.A reduced-order radiative model (Wien’s law, Stefan–Boltzmann relation, inverse-square spreading) and a benchmark-calibrated smoke dispersion model were implemented using T=1773 K, ɛ=0.85, and National Research Council endpoint concentrations. Model outputs were compared against NIST burn-flux thresholds and CDC/NIOSH irritant-concentration benchmarks. Questionnaire findings (translated from Arabic aggregate charts) were triangulated against WHO, ATSDR, CDC/NIOSH, UNICEF, and published WP case reports using an explicit, pre-defined concordance scheme.The radiative model yielded an emissive power of 476.3 kW/m2 and predicted burn-critical heat-flux thresholds within 0.62–2.90 m, depending on source area. The smoke model, C(x)=7.03×104x−1.271, predicted irritant concentrations above 3 mg/m3 to 2.74 km. Questionnaire data (75% Gaza Strip; 87% postnatal exposure) showed burns (65%), eye irritation (49%), and respiratory compromise (44%) as dominant injuries, with 28% reporting combined physical and psychological effects — all directionally consistent with authoritative evidence, although self-reported injuries could not be causally attributed to WP. Together, these outputs provide a reproducible, bounded quantitative bridge between WP thermophysics, acute toxicology, and paediatric rehabilitation need.
Neonatal burns are rare, with just over 100 cases reported in the past four decades. While dermal substitutes have been successfully used in paediatric burns, their use in neonatal burns has not been described. We report a case of a 19-day-old female neonate with 17% total body surface area (TBSA) scald burns, with significant areas of deep partial and full thickness burns. Following initial resuscitation and debridement, single-stage MatriDerm® application with immediate split-thickness skin grafting (STSG) was performed over deep burn areas. Near complete graft take was achieved by post-operative day 7. At 1-year post-burn, grafted areas remained stable with good subjective pliability. To our knowledge, this is the first reported use MatriDerm® in neonatal burns. We describe its successful use and report short-term benefits in the coverage of acute neonatal burns.
