Importance of clothing removal in scalds.

Abstract

To test the hypothesis that prompt removal of clothing after scalds lessens the severity of injury. This experimental study and case series was carried out in the Burn Centre of a tertiary hospital in Hong Kong. An experimental burn model using Allevyn (Smith & Nephew Medical Limited, Hull, England) as a skin substitute was designed to test the effect of delayed clothing removal on skin temperature using hot water and congee. Data of patients admitted with scalding by congee over a 10-year period (January 2005 to December 2014) were also studied. A significant reduction in the temperature of the skin model following a hot water scald was detected only if clothing was removed within the first 10 seconds of injury. With congee scalds, the temperature of the skin model progressively increased with further delay in clothing removal. During the study period, 35 patients were admitted with congee scalds to our unit via the emergency department. The majority were children. Definite conclusions supporting the importance of clothing removal could not be drawn due to our small sample size. Nonetheless, our data suggest that appropriate prehospital burn management can reduce patient morbidity. Prompt removal of clothing after scalding by congee may reduce post-burn morbidity.