E-cigarette burn injuries: Comprehensive review and management guidelines proposal

Area of Science:

• Trauma Surgery
• Burn Management
• Consumer Product Safety

Background:

• Electronic cigarettes (ECs) are associated with thermal, chemical, and blast injuries due to device or battery malfunctions.
• Reported injuries include burns, soft tissue, and bony trauma, necessitating a review of current management strategies.

Purpose of the Study:

• To systematically review all reported burn injuries associated with electronic cigarettes.
• To summarize the mechanisms, types, and severity of EC-related burns.
• To focus on the immediate management and surgical treatment of these injuries.

Main Methods:

• A comprehensive literature search was conducted on PubMed, EMBASE, and Medline for case reports and series published since 2014.
• Search terms included "electronic cigarette," "e-cigarette," "vaping," and "burn."
• Data on injury mechanisms, burn characteristics, and patient outcomes were extracted and analyzed.

Main Results:

• Ninety patients from 19 publications were included, with a male predominance (95.6%) and a mean age of 30.1 years.
• Flame burns were most common, with a mean total body surface area (TBSA) affected of 4.9%.
• Surgical interventions like skin grafting were performed on 22 patients, while 42 were managed conservatively.

Conclusions:

• Electronic cigarette-associated burns are likely underreported and involve combined thermal and chemical components.
• Battery malfunction is a primary suspected cause, leading to thermal runaway and potential explosions.
• A standardized treatment algorithm is proposed due to the lack of agreed-upon management protocols for EC-related burn injuries.