A few days ago, I met such a patient. Her name is Xiao Wang. At the age of 20, Because of the cold weather, I bought a hand warmer online, I like to put my hand warmer under my body when I sleep. One night, Xiao Wang was tired and slept soundly. He woke up in the morning and felt pain on the outside of his left lower leg, with local redness and small blisters. After that, he broke and scar. Due to long-term failure to heal, Xiao Wang went to the hospital. After the doctor checked, he found that the original hand warmer scalded the skin, and the skin at the scalded place was necrotic. After the doctor’s treatment of [excision of necrotic tissue] [transplantation of surface skin graft], the wound healed.
Can hand warmers really cause such severe burns?
People often say that scalding also belongs to burn, which refers to the type of wound that occurs on skin and other tissues and organs due to contact with hydrothermal solution, high-temperature gas, flame, etc. It is also called thermal injury. The degree of thermal damage to skin and subcutaneous tissues mainly depends on the contact temperature and the duration of thermal action.
Generally speaking, continuous contact with hot water at 44 ℃ for more than 6 hours will lead to irreversible skin damage. Under the temperature between 44 ℃ and 51 ℃, the longer the heat action time, the more serious the skin damage. When the temperature is higher than 51 ℃, burns, even deep burns, can occur in a short time of contact.
The actual use temperature of rechargeable hand warmers and foot warmers on the market is between 40 ℃ and 50 ℃ on average. Generally speaking, one charge can last for several hours. However, this [not too high temperature] contact time for a long time will cause the so-called [low heat scald].
Still can’t believe it? You must know that [boiling frogs in warm water] is impossible.
It is true that frogs cannot be boiled in warm water. Short-term contact with low-temperature heat sources, continuously flowing blood can take away heat, thus effectively preventing heat accumulation from causing damage to tissues. However, if you come into contact with the heat source for a long time and local tissues are under pressure, such as pressing hand warmers and hot water bags under your feet and on your body during sleep, local blood flow will be blocked and heat energy will accumulate, which will lead to damage.
Under the conditions of deep sleep, paralysis, anesthesia, etc., using hot water bags and hand warmers close to the skin to keep warm often cannot immediately find skin damage caused by low heat, while some patients with low heat burns have actual wound depth as deep as muscles or periosteum-in other words, hand warmers have [cooked] the skin and subcutaneous tissues of the patients little by little! In addition, the elderly and diabetics are also prone to low-heat burns due to poor peripheral circulation, slow feeling of heat and pain, insensitivity to low-temperature heat sources, and long-term use of heating equipment.
How serious is the cryogenic burn?
Whether scar will be left or not is related to the depth of skin injury. The judgment of burn depth is simply as follows:
I degree burn
Clinically, I-degree burns only hurt the superficial layer of the epidermis. The wound surface of the patient is mainly characterized by local redness and swelling, accompanied by pain and burning sensation, without blisters or scars.
Second degree burn
Because the dermis is injured, blisters of different sizes will appear on the wound surface, also known as [blister burn]. Deep II degree burn wounds are easy to leave scars after healing.
III degree burn
As the whole layer of skin and subcutaneous tissue (including nerve tissue) are destroyed, there is no obvious pain on the wound surface of degree III burn, and large-area scar formation will occur after injury, which is easy to lead to deformity and often requires surgical treatment.
In some patients with low fever scald, the wound surface is mainly red, swollen and blistered, which looks like degree II, but the actual burn depth can reach degree III or above. Why is this?
It turns out that at the beginning of cryogenic scald, The level of skin damage is relatively shallow, A small blister similar to a second-degree burn was formed between the dermis and epidermis. At this time, If the heat source is removed in time, the injury will no longer develop. However, scalded people often fail to find the injury in time due to various reasons. The continuous action of the injury factors further injures the deep dermis and subcutaneous tissues, resulting in degree III or more burns, while the small blisters formed earlier still exist.
What about burns?
If burns and scalds unfortunately occur in daily life, some emergency treatment methods and techniques can help patients minimize injuries. Correspondingly, other incorrect treatment methods should never be done.
Correct: Remove the clothes on the scalded part immediately, and wait for the doctor to deal with the clothes sticking to the skin.
Error: Forcibly tear off clothes stuck to the skin.
Correct: Soak the scalded part in cold water or gently rinse it with running water for more than 10 minutes until the pain is relieved.
Error: Use ice cubes to cool down directly.
Correct: Bandages/clean clothes cover minor scalding wounds, sterile gauze/plastic wrap/clean plastic bags protect wounds.
Error: Pick through blisters with needles or fingernails.
Prevention of infection
Correct: Take tetanus needle to keep the wound clean.
Error: Apply oily ointment/salt/soy sauce/flour/toothpaste and the like.
Relieve swelling and pain
Correct: Raise the burned limb to be higher than the heart plane, and take Tylenol, ibuprofen and other painkillers orally when necessary.
Error: Use alcohol, iodophor, red and blue liquid medicine and other agents to treat the wound surface.
Proper Use of Hand Warmer
As mentioned earlier, thermal damage mainly depends on contact temperature and thermal action time. Having grasped the essential causes of these two thermal damage, low-heat scald is still easy to prevent.
Control the temperature of the heat source
For adults with normal physique, when the temperature of the heating equipment can be adjusted, please set the temperature at about 40 ℃. For heating equipment with poor temperature control such as hot water bags and Mrs. Tang, do not directly pour boiled water into it, replace it with warm water. Do not fill the hot water too full, about 70%, and it is better to wrap a towel outside when using it.
Control contact time
The continuous heating time in the same part should not exceed 2 hours, and the heating equipment should not be used after lethargy or taking sleeping and sedative drugs, and it is not recommended to use electric blankets, baby warming and other products all night.
Prevent direct contact
No matter what kind of heating equipment, do not directly contact the skin, especially the skin thin parts such as elbows and inner thighs. Keep a safe distance of more than 50 cm when using electric heaters such as small sun.
An exceptional crowd
Children’s skin is delicate, and parents should supervise the use of heating equipment. The temperature of the equipment should be appropriately lowered and the use time should be appropriately shortened. The elderly, diabetics, anesthesia, paralysis and other patients with limb pain and temperature loss or loss, family members should pay more attention when helping them to keep warm.
Purchase Qualified Products
In addition, when choosing all kinds of heating products, one must also keep one’s eyes open. Don’t buy inferior goods cheaply. Take hand warmer as an example, The author roughly searched a treasure. In the introduction of hand warmers with the first few sales volume, none of them indicated the actual use temperature range and suggested use time. Even important documents such as production license and quality guarantee are difficult to find. When you choose such heating facilities, you must have more than one product.
Although hooligans always move (freeze) their hands (freeze) their feet in winter until the spring girl is completely cleared, we just need to put down our cell phones and leave the computer, get up and exercise for more than ten minutes, and then our bodies will heat up immediately, and we can also keep fit and lose weight. Why not?
Responsible Editor: Ding Ruoshui
This article is exclusively authorized by the author to be used by Clove Garden and refuses any other form of reprinting.