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Burns from a Stove Burst: Analysis of 34 Cases

Authors:
  • Aestheric Plastic Surgery & FUE Hair

Abstract

Burns continue to be a major environmental factor responsible for significant morbidity and mortality in developing countries and, in particular, burns due to stove bursts are a major problem. Two types of stoves are available in Pakistan: gas stoves and kerosene stoves. The state is considered of patients burned by stove bursts in general, and also with specific reference to 34 adult patients admitted with stove burns to our hospital in Pakistan. Various treatment options were used, and the patients' treatment and outcome are reported. The continued commercialization of such stoves, and especially of the gas stove, is is a cause of serious and permanent consequences that represent a danger for the population. Proper care should be observed when handling them because, as always, prevention is better than cure.
Introduction
Burns are among the most devastating of all injuries,
with outcomes spanning the spectrum from physical im-
pairments and disabilities to emotional and mental conse-
quences.1Most burns are caused by thermal energy, in-
cluding scalding and fires, the majority being due to ex-
posure to chemicals, electricity, ultraviolet radiation, and
ionizing radiation. Globally, fire-related burns are respon-
sible for about 265,000 deaths annually.2Over 90% of fa-
tal fire-related burns occur in developing countries, with
south-east Asia alone accounting for over half of these
fire-related deaths.2Hospitals which treat burn patients have
reported a great number of burns in people using kerosene
stoves.3,4
The principle aim of this study was to describe the state
of patients burned by stove burst.
Materials and methods
This study was carried out in the Department of Plas-
tic Surgery, Pakistan Institute of Medical Sciences, Islam-
abad, Pakistan, from January 2002 to December 2003.
Adult patients of either sex above the age of 12 years were
included. Patients below the age of 12 years were excluded
as they were managed at the Children’s Hospital, Pakistan
Institute of Medical Sciences. Patients were included in
the study only if they had a clear history of burns from
stove bursts and were admitted to hospital. Patients with
burns from all other causes were excluded.
Management started with the standard protocol for air-
ways, breathing, and circulation. All the patients were re-
suscitated. They were daily washed and dressed, using 2%
silver sulphadiazine cream. The patients underwent vari-
ous surgical treatments including fasciotomy, split-thick-
ness skin grafting (STSG), full-thickness skin grafting
(FTSG), flap coverage, etc. Patients with superficial burns
were managed conservatively.
Results
Atotal of 34 patients (3 males, 31 females) were ad-
mitted with stove burns. The average age of the females
was 25.9 yrs and of the males 29 years (range, 14-40 yr).
The majority of the patients (58.8%) belonged to the
younger age group (21-30 yr). Most of the patients were
housewives (73.5%) (Table I); 61.8% of the patients were
unmarried, against 38.2% married. The patients had an av-
erage of 36.0% total burn surface area. The abdomen and
lower limb were the most affected areas (29.4%), followed
by the upper limb (26.5%) and chest (23.5%). Inhalation
injury was observed in 14.7% of the patients. The aver-
age hospital stay was 21.8 days (range, 18-43 days). Var-
ious treatment options were used, including fasciotomy
(20.6%), STSG (76.5%), FTSG (5.9%), flap coverage
Annals of Burns and Fire Disasters - vol. XX - n. 4 - December 2007
173
BURNS FROM A STOVE BURST: ANALYSIS OF 34 CASES
Ahmad M.,1Hussain S.S.,2Malik S.A.3
1Aesthetic Plastic Surgery, Chaklala, Rawalpindi, Pakistan
2Aesthetic Artistry, Islamabad, Pakistan
3Shifa International Hospital, Islamabad, Pakistan
SUMMARY.Burns continue to be a major environmental factor responsible for significant morbidity and mortality in developing
countries and, in particular, burns due to stove bursts are a major problem. Two types of stoves are available in Pakistan: gas stoves
and kerosene stoves. The state is considered of patients burned by stove bursts in general, and also with specific reference to 34
adult patients admitted with stove burns to our hospital in Pakistan. Various treatment options were used, and the patients’ treat-
ment and outcome are reported. The continued commercialization of such stoves, and especially of the gas stove, is is a cause of
serious and permanent consequences that represent a danger for the population. Proper care should be observed when handling
them because, as always, prevention is better than cure.
Table I - Occupation of patients
Occupation Number
Housewives 25
Labourers 2
Dependants 4
Farmers 2
Carpenters 1
Total 34
(5.9%), and tracheostomy (8.8%) (Table II). Conservative
treatment alone was opted for in 14.7% patients. Wound
infection was observed in 5.9% of cases and partial loss
of skin graft in 8.8%. Three patients died (8.8%), all fe-
males (Fig. 1).
Discussion
Burns continue to be a major environmental factor re-
sponsible for significant morbidity and mortality in devel-
oping countries. Burns due to stove bursts were a major
finding reported in other studies.3-7
Two types of stoves are available in Pakistan: gas stoves
and kerosene stoves. Gas stoves mostly contain liquid
petroleum gas (LPG) (Fig. 2). Two types of kerosene stoves
are available: domestic and commercial (Figs. 3, 4). Com-
mercial kerosene stoves are rapidly being replaced with
gas stoves as they are more economical and also because
of the increase in outdoor activities linked to the devel-
opment of leisure and free time. In our study kerosene was
the flammable liquid used in the stoves.
Stoves used for domestic purposes consist of a base
which contains kerosene. Multiple cotton thread wicks ex-
tend from the base to the upper chamber. An outside sec-
ond chamber is used to protect the flames from the air.
The exact mechanism of stove burst is not known, but it
is thought that some of the kerosene in the lower cham-
ber is converted into gaseous form, which suddenly es-
capes and catches fire, resulting in stove burst. The stove
used for commercial purposes consists of a chamber in
which air is pumped into kerosene in order to make the
gaseous form.
When such stoves burst, it is mostly the front parts of
body that are involved (face, neck, front of chest, legs, arms,
and hands). The lower abdomen and upper thighs are spared
initial injury, but when the person stands up the hot
flammable liquid may flow down and involve the lower ab-
domen and upper thighs (Fig. 5). The back is usually spared.
The background history of the burn is of utmost im-
portance in such cases and may help in medico-legal as-
pects. If only the front parts of the body are involved, it
may be a case of accidental stove burst. But if the back
parts or the whole body are affected, it may be a case of
attempted homicide.
Careful handling of the stoves is of utmost importance
and is key to preventing an injury. Nearly all the burn pa-
tients in this study belonged to a low socio-economic cat-
egory and they did not observe the necessary precautions
when handling or using the stoves.
In a study conducted in a burns unit in Pakistan,641%
of the patients had flame burns. Similarly, in another study
Annals of Burns and Fire Disasters - vol. XX - n. 4 - December 2007
174
Table II -Treatment options
Treatment Number of patients
Male Female
Fasciotomy 1 6
Split-thickness skin graft 1 25
Full-thickness skin graft - 2
Flap coverage 1 1
Tracheostomy - 3
Conservative treatment 1 4
Fig. 1 -Patients’ marital status.
Fig. 2 -Gas stove. Fig. 3 -Domestic kerosene stove. Fig. 4 -Commercial kerosene stove.
by Mabrouk et al.,340% of 759 patients had burns due to
stove burst. The percentage of stove bursts was even high-
er (52%) in a study conducted in Karachi, Pakistan.4
Surprisingly, 91% of the patients in our study were fe-
male, and the mean age was 36.0 yr - 73.5% of the pa-
tients were housewives. These findings are much higher
than those of studies conducted in Pakistan.4,6
The mortality in our study was 8.8%, which is much
less than the 29.7% found by Khan et al.6The average to-
tal burned surface area in our study was 35.6% - it was
much less (11-20%) in Khan’s study.6
This type of burn has already been described in the lit-
erature. In 1985, Saxby et al. published a series of 31 pa-
tients burned in similar conditions, with one death.8Sim-
ilarly, Richards et al. expressed concern about the persis-
tence and frequency of this type of burn.9
These stoves are dangerous products. However, acci-
dents are usually due to the fact that the victims do not
follow the instructions and do not observe the necessary
precautions. In some cases, the stoves were refilled while
still burning, a strictly forbidden practice. Also, the com-
panies that make these stoves do not always observe the
due precautions and safety check-ups. These stoves pro-
vide a very cheap alternative to electric stoves, especially
in low socio-economic groups.
The continued commercialization of this kind of stove,
and especially the gas stove, is causing serious and per-
manent consequences that represent a danger for the pop-
ulation. All burns centres confronted with this type of burn
should pass the information on to the public authorities so
that the government in each country can take the appro-
priate measures.
Conclusion
Proper care should be observed in handling gas and
kerosene stoves. Prevention is always better than cure. In-
juries due to stove burst are long-lasting and, more often
than not, preventable.
Annals of Burns and Fire Disasters - vol. XX - n. 4 - December 2007
175
Fig. 5 -Initial injury by stove burst.
RÉSUMÉ.Les brûlures continuent à être un facteur environnemental important responsable d’une morbidité et d’une mortalité
significative dans les pays en voie de développement et, en particulier, les brûlures causées par l’explosion d’un poêle constituent
un grave problème. Au Pakistan deux types de poêle sont disponibles : les poêles à gaz et les poêles à kérosène. Les Auteurs
considèrent la condition des patients brûlés à cause des explosions de poêle en général et, en particulier, ils présentent les données
de 34 patients adultes hospitalisés dans leur hôpital au Pakistan. Ils ont fait recours à diverses options thérapeutiques, que les Au-
teurs décrivent avec les résultats finaux. La continuation de la commercialisation de ces types de poêle, et en particulier du poêle
àgaz, provoque des conséquences graves et permanentes qui constituent un danger pour la population. Il faut exercer la correcte
attention dans leur maniement parce que, comme toujours, mieux vaut prévenir que guérir.
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This paper was received on 16 August 2007.
Address correspondence to: Dr Muhammad Ahmad,
Aesthetic Plastic Surgery, H. No. D-28, Block-6, Faisal
Colony, Airport Link Road, Chaklala, Rawalpindi,
46200 Pakistan. E-mail: plasticsurgeon999@yahoo.com
... There were 4 cross-sectional studies, 5 prospective cohort studies, 14 retrospective cohort studies, two case series studies and three studies with both retrospective and prospective components. Three studies were from Bangladesh, 22 -24 1 from Sri Lanka, 19 4 from Pakistan 15,32,34,35 and 20 from India. 9 -14,16 -18,20,21,25 -31,33,36 Data for all three studies from Bangladesh were obtained from a nationwide survey. ...
... 9,11,12,22,26,27,30 Among children, scalds tended to be the most common type of injury. 13,15,25,31 Severity Nine studies 9,12,13,15,18,19,28,34,35 examined the %TBSA, which ranged from 4 to 100%. The majority of injuries tended to be less severe; Sarma 28 stove bursts also found that injuries tended to be more severe, with an average %TBSA of 36%. ...
... The majority of injuries tended to be less severe; Sarma 28 stove bursts also found that injuries tended to be more severe, with an average %TBSA of 36%. 35 Iqbal and Saaiq 15 reported a higher %TBSA than the average among hospitalized patients (27.07% versus 9.37% overall). ...
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Background Burns are a significant cause of mortality and morbidity in developing countries. We examined the epidemiology of unintentional burns in South Asia to identify trends and gaps in information.MethodsA MEDLINE/PUBMED search (1970-2011) was undertaken on empirical studies that focused on burns in India, Pakistan, Bangladesh and Sri Lanka. Data analyzed included demographics, injury details and risk factors.ResultsTwenty-seven studies were identified, mostly from India. Burns were more common among males at younger ages (0-12 years) and among females from adolescence onward (>14 years). Flame-related burns and scalds accounted for over 80% of burns in most cases, and were the most common types of injuries observed among children and women with most burns occurring in the home. Electrical burns occurred mostly among men. Important risk factors for burns included low socioeconomic status, being younger, wearing loose, flammable clothing and the use of kerosene. Data on care-seeking and treatment were limited.Conclusions Preventing burns in the household in South Asia, particularly around kitchen activities, is essential. Children in South Asia are susceptible to burns and are an important target population. Future research should focus on filling the gaps in burn epidemiology found in this review. © The Author 2013, Published by Oxford University Press on behalf of Faculty of Public Health.
... This method does not guarantee if the food is safe and clean to eat. All this thing may be harmful to people and environment because of the occurring open burning [2]. Wood burning contributes pollution to environment in the form of smoke when the wood was burned [3]. ...
... Stove flames are control the heat by regulate the inlet of the gas valve manually to control the temperature. According to Ahmad et al., [2], flame produced by wood stove can caused harmful to people. Hence, thermoelectric uses Peltier effect is implemented as an alternative element to a system that produce heat [6][7] and energy source [8]. ...
... Of recent, gas stoves have been widely used in most parts of Tanzania, since they are affordable compared to electric stoves. Even though the gas stoves are simple to use, accidents occur frequently because the victims do not follow the instructions and do not observe the necessary precautions when using them as it has been reported in Pakistan [18]. During this study, some patients reported to have forgotten to turn off the valves after they had put off the flame. ...
... Of recent, gas stoves have been widely used in most parts of Tanzania, since they are affordable compared to electric stoves. Even though the gas stoves are simple to use, accidents occur frequently because the victims do not follow the instructions and do not observe the necessary precautions when using them as it has been reported in Pakistan [18]. During this study, some patients reported to have forgotten to turn off the valves after they had put off the flame. ...
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