601 Burn Injuries Associated with At-home Hair Braiding

Abstract

Abstract Introduction Hair braiding that incorporates synthetic extensions has increased in popularity across all age groups. During the styling process, the ends of the braid are commonly dipped in hot water. As a result of this practice, an increasing number of patients have presented to our Burn Center after containers of recently boiled water are accidentally tipped over and spilled onto patients. Here, we report on patient demographics, outcomes, and our experience managing this injury pattern. Methods A retrospective chart review was performed of all patients who sustained burn injuries associated with at-home hair braiding presenting to an ABA-verified Burn Center between January 1, 2006 and July 31, 2020. Data on patient demographics, injury characteristics, wound management and, burn outcomes was collected. Results A total of 41 patients presented over the study period with burn injuries related to at-home hair braiding. The frequency of this type of burn increased over time, with 54% of injuries occurring in the last three years (2018–2020). The mean patient age was 7.5 years (range 0.7 – 32 years). Demographically, the vast majority of patients were under 18 years of age (90%), female (95%), and African American (98%). Seventy-three percent of injuries occurred at the patient’s home and 88% of incidents involved another person in the hair braiding process. The mean total body surface area of burn was 5% (range 1–20%). The most commonly involved areas were the back (54%), thigh/leg (37%), neck (24%), shoulder (24%), and arm/forearm (22%). Ninety percent were entirely partial thickness injuries with 10% of patients suffering some degree of full thickness injury. Ninety percent of patients required inpatient admission, and 36% of patients required at least one operative procedure. For those managed as inpatients, the average length of stay was 5.4 days (range 1–30 days). Three patients were reported to experience complications with one developing respiratory failure and two with delayed wound healing. Conclusions Hair braiding, with the use of scalding water to seal and set the ends of braids, can lead to significant accidental burn injuries. At our institution, these injuries occur predominantly in young African-American females. These burns can result in acute hospitalization and the need for surgical intervention. This is the largest series of this injury type to date with trends towards increasing frequency in the most recent time period.