Review of burns caused by bitumen and the problems of its removal

Bitumen burns are difficult to treat as the substance adheres to the skin. Twenty-four patients with such burns admitted as inpatients over a 9-year period have been reviewed. The mean size of the burn injury was 3 per cent of the total body surface area (mean full thickness burn: 1 per cent). Sixteen patients required operative treatment to achieve healing but no secondary reconstructive procedures have been performed. Twenty-two patients, who were burned at work, returned to their original employment within 2 months of injury. There was no decrease in the need for operation or decrease in the time to healing in those patients who had attempted early removal of the bitumen. Suggested principles of management are: cool the bitumen continuously with cold water until hard to dissipate the retained heat, leave the bitumen intact except around the eyes, and deroof tense blisters.