On cold winter nights, people use hot water bottles to warm their beds, then put their bodies close to the warm baby, and have a good sleep. Not to mention how happy they are. After a night of “intimate contact”, low-temperature burns to the ankles and lower back occurred.
Many people are very unfamiliar with low-temperature burns. In fact, low-temperature burns are highly seasonal and occur most frequently in winter, accounting for about 1/3 of winter burns. Don’t be careless when heating. The heating equipment should be wrapped in flannel or towels for insulation to avoid direct contact between the hot surface and the skin. The elderly should avoid prolonged contact with items that are hotter than body temperature.
Q: How do low-temperature burns occur?
Answer: Under the continuous action of low heat, although the temperature difference between the heat source and the skin is small, the surface tissue dehydrates slowly, has a large heat capacity, and conducts more heat to the deep tissue, causing thermal damage to the deep tissue to gradually accumulate. Therefore, low-temperature burns will occur if the skin is not sensitive to temperature while sleeping and is “attached” to a heating device for a long time.
Q: Why is it difficult for low-temperature burns to heal on their own?
Answer: Low-temperature burns not only cause blisters, but can also easily rupture. Unlike accidentally scratching the skin, low-temperature burn wounds are delayed and difficult to heal. Take the roasted sweet potatoes that are common on the streets in winter to explain. If the sweet potatoes are stuck to the iron stove for a long time, even though the fire is out, the sweet potatoes can still be cooked due to the stimulation of the residual heat for a long time. Low-temperature burns are often accompanied by loss of skin sensation or sensitivity or burning pain. Although the burn area is not large, it is often deep, mostly deep II to III degree injuries.
This type of burn has a long course. In the early stage, the wound surface is moist and blisters are formed. The wound surface is exposed or the base is pale after the epidermis is avulsed. After about 2 weeks, the wound surface dehydrates and dries up, forming an eschar that changes like leather. The eschar begins after 3 to 4 weeks. Rejection and melting, secretions increase, mostly yellow-green or dark red, the wound surface liquefies, and the inflammatory reaction increases. If timely intervention is not carried out, the wound infection will be further aggravated, cellulitis may occur, and even fever may occur. Therefore, once you are burned, go to the hospital for diagnosis and treatment in time to avoid delayed wound healing.
Question: Can low-temperature burns be treated only with skin grafting?
Answer: Low-temperature burns are currently divided into surgical treatment and non-surgical treatment. Although the area of the affected area is small but deep, the treatment with conventional dressing changes takes a long time, so many doctors will recommend skin grafting. Depending on the depth of the wound, the blood supply conditions of the wound base, and the patient’s requirements for appearance, repair methods such as free skin grafting, island flaps, and myocutaneous flaps can be flexibly selected.
Traditional Chinese medicine also has some experience in treating such low-temperature burns. It can use traditional Chinese medicine surgical techniques, prescriptions and modern methods to combine internal and external treatment, so as to achieve the effect of curing small and medium-sized hot water bottle burns and other low-temperature burns. At the same time, for those with other underlying diseases, active treatment of the underlying disease should be carried out on the basis of wound treatment.
Question: Will low-temperature burns also cause scarring?
Answer: The scar hyperplasia caused by low-temperature burns mainly depends on the depth of the injury. If only the epidermis or superficial dermis is involved, the surface of the injured area will be flat and soft, but may appear rough or have pigment changes. Such scars will often fade as the injury heals. However, if the damage involves the deep layer of the dermis, causing local thickening and hardening, and the scar is higher than the surrounding normal skin, then there is a greater risk of scar hyperplasia. For this type of scar, various physical therapies (such as compression therapy), medications, or other products (such as scar patches) can be considered to reduce discomfort. Wang Yongling (Attending Physician) Liao Mingjuan (Deputy Chief Physician) (Department of Traditional Chinese Medicine, Ninth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine)