The cost of keeping warm: a relationship between a rise in the cost of domestic energy and burn injuries caused by personal heating equipment.

INTRODUCTION: During 2022-2023, the UK found itself in the midst of a domestic energy crisis, with the average domestic gas and electricity bill rising by 75% between 2019 and 2022. As a result, the use of hot water bottles, radiant heaters, and electric blankets increased. An unintended consequence of this may be an increase in burn injuries caused by misfortune, misuse, or the use of items in a state of disrepair. PURPOSE: The aim of this study was to explore any increase in referrals to a single burns centre in England for injuries caused by hot water bottles, radiant heaters, or electric blankets. METHODS: This was a retrospective study of a prospectively maintained database of referrals. All referrals between January 2022 and January 2023 were selected and compared with the same period from 2020-2021 (before the rise in energy prices). Referrals were screened for the terms "hot water bottle," "electric heater," "electric blanket," and "heater." Total referrals in each period, demographic data (age, gender), anatomical location and the mechanism of injury were compared between cohorts. RESULTS: We found a statistically significant increase in the number of burns relating to heating implements between 2020/21 and 2022/23, rising from 54 to 81 (p = 0.03) - a 50% increase in injuries. Injuries in working age adults increased significantly (52% to 69%, p < 0.05). The most frequently injured area was the leg (30%) followed by the hand (18%). The commonest type of injury described was scald (72%). We found a moderately-strong correlation between the number of referrals and the average cost of energy in 2022-23. CONCLUSION: The number of injuries sustained by people using personal heating equipment is significantly increasing, which correlated with the rise in domestic energy prices. The most affected demographic appears to be working age adults, with wider implications around lost work-time yet to be explored. Further prospective, population-based work is indicated to assess the strength of the correlation seen in this study.

Burns related to electrosurgery - Report of two cases / Queimaduras relacionadas à eletrocirurgia - Relato de dois casos

Abstract Electrosurgery is a technology developed over the last few years and has become a very important tool in modern surgery. Most of the equipment is considered safe, although there are risks related to its use. Several lesions may be caused by electrocautery, and burns are the most common and feared. We report two cases of burns related to use of electrocautery and promote a literature review, because knowledge of electrosurgery fundamentals, its correct use, the choice of a safety device, constant monitoring, and immediate investigation before any suspicions surely can improve the operational experience for both surgeon and patient.

Resumo A eletrocirurgia é uma tecnologia que se desenvolveu muitos nos últimos anos e se tornou um instrumento de grande importância na cirurgia moderna. A maioria dos equipamentos é considerada segura, embora existam riscos relacionados ao seu uso. Várias lesões podem ser causadas por eletrocautérios, as queimaduras são as mais frequentes e temidas. Relatamos dois casos de queimaduras relacionadas ao uso do bisturi elétrico e promovemos uma revisão de literatura, pois o conhecimento dos fundamentos da eletrocirurgia, seu uso correto, a escolha de um equipamento seguro, o monitoramento constante e a investigação imediata diante de quaisquer suspeitas com certeza podem melhorar a experiência operacional para ambos, cirurgião e paciente.

Análise de pacientes internados por queimadura elétrica / Analysis of patients admitted for electrical burns

Introdução: Quando se comparam os dados referentes à gravidade, como uso de parâmetros como grau de incapacidade permanente das vítimas sobreviventes, enfatiza-se ainda mais a gravidade dos acidentes por energia elétrica. As vítimas costumam ser adultos jovens, do sexo masculino, em ambiente de trabalho. Do ponto de vista econômico, os acidentes causados por energia elétrica são de alto custo, pois costumam incidir sobre adultos jovens e tecnicamente diferenciados. O objetivo desse estudo é analisar os casos de acidentes ocupacionais decorrentes de queimadura elétrica em nosso serviço, com o intuito de conscientização, e alertar instituições governamentais e não-governamentais quanto à importância de sua prevenção. Método: Estudo retrospectivo transversal das internações dos anos de 2009 e 2010, a partir da coleta de dados em banco de dados do Centro de Tratamento de Queimados do Hospital Municipal Souza Aguiar, sendo analisados os seguintes dados: sexo, idade, local de ocorrência, porcentagem da superfície corporal queimada (SCQ), época do ano e taxa de mortalidade. Resultados: Foram acometidos 26 pacientes por queimadura elétrica, sendo todos do sexo masculino, com idade média de 29,5 anos. O acidente de trabalho foi o mais importante representando 38,46%, seguido de via pública (23,07%) e domiciliar (15,38%). A porcentagem do SCQ média: 0-9% (11,53%), 10-19% (34,61%), 20-29% (30,76%), 30-39% (30,76%) e 40-49% (3,84%). A taxa de óbito foi de 7,69%. Conclusão: Aconselha-se não fazer economia quanto aos gastos com prevenção e investir na pesquisa de novos métodos de tratamento capazes de diminuir o período de inatividade e o grau de incapacidade do trabalhador.

Introduction: When comparing the data on gravity, through parameters such as the degree of permanent disability of the surviving victims, it is emphasized further by the severity of electrical accidents. The victims are usually young adult males in the workplace. From an economic standpoint, accidents caused by electricity are expensive, because young adults tend to focus on differentiated and technically. The purpose of this study is to analyze the cases of occupational accidents due to electrical burn in our service, in order to raise awareness and alert governmental and non-governmental organizations on the importance of prevention. Methods: Cross-sectional retrospective study of admissions for the years 2009 and 2010, from the collection of data in the database of the Burn Treatment Center of the Hospital Municipal Souza Aguiar, and analyzed the following data: sex, age, place of occurrence, percentage of burned surface área (BSA), time of year and the mortality rate. Results: Twenty-six patients were affected by electrical burn, being all male, mean age 29.5 years. The accident was the most important work representing 38.46%, followed by road (23.07%) and home (15.38%). The average percentage of the BSA: 0-9% (11.53%), 10-19% (34.61%), 20-29% (30.76%), 30-39% (30.76%) and 40-49% (3.84%). The death rate was 7.69%. Conclusion: It is advisable not to make the economy and spending on prevention and investing in research of new treatment methods can reduce the period of inactivity and the degree of disability of the worker.

Effects of electrocautery to provoke endovascular thermal injury / Efeitos do eletrocautério para provocar lesão térmica endovascular

PURPOSE: To investigate the effects of a new electrocautery device to provoke endovascular venous thermal injury. METHODS: An experimental endovascular electrocautery was placed inside eight ex-vivo bovine saphenous veins models. Each one was divided in eight segments and progressive intensities of electric energy liberated. The macroscopic and microscopic effects were analyzed. RESULTS: Forty bovine saphenous veins segments were studied. The higher the electric energy applied the greater the nuclear picnosis and more intense the cytoplasmatic shrinkage and electrocoagulation effects. CONCLUSION: The experimental endovascular electrocautery device demonstrated to be both capable of inducing the destruction of the intimal layers of the studied vein model and provoke endovascular thermal injury.

OBJETIVO: Investigar os efeitos de um modelo experimental de eletrocautério em provocar lesão venosa térmica endovascular. MÉTODOS: O eletrocautério endovascular foi colocado dentro de oito modelos experimentais de veia safena bovina. Cada uma foi dividida em oito segmentos e intensidades progressivas de energia elétrica liberada. Os efeitos macroscópicos e microscópicos foram analisados. RESULTADOS: Foram estudados quarenta segmentos de veia safena bovina. Quanto maior a energia elétrica aplicada pelo eletrocauterizador endovascular maiores foram as alteraçoes de picnose nuclear e mais intensa a retração citoplasmática observada. CONCLUSÃO: O eletrocautério endovascular experimental demonstrou ser capaz de induzir a destruição da camada íntima e provocar lesão térmica endovascular.

Utilization of skin flap for reconstruction of the genitalia after an electric burn

The objective of this article is to describe a case of an electric burn to the genitalia causing scrotal and testicular lesion, and the subsequent reconstruction using a skin graft. The patient was a 10-year-old boy who was victim of an electric burn that harmed the genitalia. There was extended skin loss, penile, scrotal and partial testicular lesion. The treatment consisted of plastic surgery to reconstruct the genitalia with skin flaps grafted on the left thigh, the scrotum and the base of the penis. The patient recovered well and was discharged after two weeks. We concluded that in severe cases of electric burns to the genitalia, skin graft offer a good therapeutic option.

Lesiones por electricidad en pediatría / Injuries by electricity in pediatrics

Desde el comienzo de los tiempos la gente ha visto la electricidad con miedo, poco se sabía del mecanismo de daño hasta que conenzó su uso controlado hace alrededor de 150 años; desde entonces, se han podido definir sus propiedades físicas y a través de éstas conocer la fisiopatología de sus efectos en el ser humano. Las lesiones por corriente eléctrica son relativamente poco frecuentes, constituyendo entre el 3 y 8,9 por ciento de las admisiones en las unidades de quemados; las tasas de natalidad también son bajas; sin embargo, la incapacidad que generan, tanto a corto como a largo plazo constituye el principal motivo de preocupación, sumado al hecho de que con la creciente disponibilidad de artefactos eléctricos la frecuencia de este tipo de lesiones ha ido en aumento. Según diversos estudios clínicos, el 22 por ciento de los pacientes hospitalizados por quemaduras eléctricas corresponde a niños entre 0 y 18 años, y en el 73,7 por ciento de los casos el accidente se produce mientras juegan, de lo cual se desprende que la prevención es un pilar fundamental en el manejo de este tipo de lesiones en pediatría