Steam burn on nose by heated, humidified high flow nasal cannula in neonate
Dear Editors, Heated, humidified high flow nasal cannula (HHHFNC) is commonly used as a non invasive mode of respiratory support in the NICU (Neonate intensive care unit) The safety and efficacy of HHHFNC have not been compared with other modes of non invasive support in large randomised trials (1) A steam burn by HHHFNC is extremely rare. Steam burns are quite common, and most of these accidents happen in the kitchen. The case presented a steam burn on the nose because of the abnormal action of the HHHFNC temperature modulator, which has not been seen before. A 12 day old infant was presented to treat a burn wound because of HHHFNC (VH 2600, MEKICS Co. Chuncheon, South Korea) which was caused by the failure to set an appropriate temperature (Figure 1) His nose had been exposed to heated humidified steam for just 2 3 seconds. His nose had an approximate 3 x 25 cm2 sized deep second degree burn with crust formation because of coated discharge (Figure 2) We began treatment with foam dressing. The burn was healed with epithelisation. We changed the dressing to an allogenic keratinocyte sheet, Kaloderm (TEGOSICENCE, Seoul, South Korea) and hydrocolloid according to decreased discharge. After 8 days, the burn wound was totally healed without complications (Figure 3) Without dressing material, ointment was applied for moisturising. At 2 month follow up, he had no wound problems, such as hyper/hypopigmentation, contracture or hypertrophy (Figure 4) Burn injuries can be classified as minor, moderate or major depending on criteria such as depth, extent of injury and age (2) Hot water scalds are the most common cause of paediatric burn admissions (3) The depth of a scald injury depends on the water temperature, skin thickness and duration of contact (3) Boiling water often causes a deep dermal burn unless the
International wound journal