The flaming gypsy skirt injury

On review of admissions over a 12-month period, we noted a significant number of women presenting with gypsy skirt burns. We describe all six cases to highlight the unique distribution of the wounds and the circumstances in which the accidents occurred. Four skirts were ignited by open fire heaters: two skirts ignited whilst the women were standing nearby, distracted with a telephone conversation; one brushed over the flame as she was walking past the heater; other whilst dancing in the lounge. One skirt was ignited by decorative candles placed on the floor during a social gathering. Another skirt was set alight by cigarette ember, whilst smoking in the toilet. Percentage surface area burned, estimated according to the rule of nines, showed that gypsy skirt burns were significant ranging from 7 to 14% total body surface area (TBSA) and averaging 9% TBSA. Two patients required allogenic split-skin grafts. Common sense care with proximity to naked flame is all that is needed to prevent this injury.