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Abstract: This case is of an elderly female patient who came to the hospital with burns on the dorsum of both feet as well as part of the lower leg due to an explosion of a boiling water bottle while opening water. She was diagnosed as having second-degree burns on both lower extremities. In addition to anti-infection medication change treatment, cleanup of decayed skin was performed and the trauma was covered with a pigskin biological dressing for protection, and the patient’s trauma recovered well after 10 days with no obvious scars.
[Basic information] Female, 65 years old
Disease Type】Double lower extremity second degree burns
Hospital】The First People’s Hospital of Jiujiang City
Date of consultation】January 2022
Treatment plan】Medication (cefotaxime sodium, compound cypress lotion) + surgery (burn wound debridement + bio-skin covering burn wound debridement)
[Treatment period] 10 days of inpatient treatment
【Treatment effect】The skin of the wound completely healed, no exudate, basically no scar
I. Initial consultation
The patient complained that a hot water bottle filled with boiling water suddenly exploded and the hot water sprayed directly on both legs, which subsequently scalded the dorsum of both feet and part of the lower leg, causing many blisters on the scalded area. After admission, according to the degree of scalding, the patient was diagnosed as II degree scalding of the lower extremities, and was then admitted to the hospital for injury treatment and medication. After effective treatment, the traumatic skin healed completely without exudate and basically without scars.
II. Treatment process
After admission, the patient was given basic routine blood and blood biochemical tests, and the blood picture was elevated because of the trauma emergency reaction, followed by cefotaxime sodium drip for anti-infection treatment; and on the second day after admission, burn wound debridement + bio-skin covering was performed in the ward. The blisters were thoroughly removed and the decayed skin present were all removed, then washed with compound cypress lotion fully and repeatedly, and finally the pigskin bio-dressing was covered over the wound and protected with pressure bandage, and the patient was instructed to elevate both feet.
III. Treatment effect
After the treatment of dressing change, wound cleaning and anti-infection, there was basically no necrotic material on the surface of the wound, and the base of the wound was in full contact with the pigskin bio-dressing after covering the pigskin bio-dressing. 7 days later, the pigskin dressing was removed and the wound was basically healed, the new skin had basically started to grow, there was no pain and exudate, and the patient could walk normally, although there was mild swelling and pain when walking, but it was all normal. The patient was discharged at the 10th day of hospitalization.
IV. Notes
We are glad that after timely treatment, the skin lesion of the scalded area has basically healed and there is no more exudate, and the patient also resumed walking normally. However, it is recommended that the patient still needs to pay attention to avoid full exposure of the trauma or early exposure to sunlight or scratching to prevent infection after discharge. Note that the newly healed trauma may become swollen and even stinging when walking, which is a normal phenomenon during the recovery period. Some even have small blisters, which are caused by friction during the activity. As long as the wound is protected from infection, it can generally recover in 2-3 days. In life, a light diet should be taken to avoid spicy and irritating foods that aggravate infection and are not conducive to wound healing; pay attention to local cleanliness.
V. Personal insight
Burns are mostly caused by accidents, patients are mostly worried and nervous, considering whether the local will leave scars, whether the wound is too large will affect work and life. In fact, there is no need to worry about the above-mentioned situation, as long as the patient cooperates effectively in the whole treatment process, for not very serious trauma, after active and correct treatment, generally can reap a good prognosis. If the patient does not cooperate and makes mistakes on his own, it may lead to aggravation of the wound infection and even require surgery for repair later on, which will not only increase the pain but also the treatment time.