Hot Liquid Injury

A Blister

A common accidental injury, scald; is seen in women of India following spillage of hot liquid over body. The sufferers are mostly the housewives. Hot liquid may range from water to oil. It occurs following serving of hot tea, cooking fishes and while extracting excessive water from cooked rice etc.There may be simple redness to blister formation. It may get infected and consequent delay in healing.
As a first-aid measure, the hot liquid should be washed off with copious amount of tap water; the part be kept in water for at least 10 minutes. That will cool the part of body and give a soothing touch. Many times, this small step will prevent blister formation. I have seen people applying tooth paste in the hope of getting relief, which should not be performed. A silver sulphadiazine cream if available should be applied. The victim is to be shifted to a nearby hospital.
In the hospital, the percentage of scald is assessed in the same line as employed for burn; the rule of nine of Wallace. A replacement fluid, if required will be administered; an analgesic will be given as well as immunization against tetanus. A suitable antibiotic is prescribed.
The important aspect of treatment is dressing. An occlusive dressing is preferred over an open dressing. Blisters more than 2 cms. in diameter are to be de-roofed after cleaning the dirt, if any. A soothing antibacterial cream like silver sulphadiazine is to be applied, over that sterile paraffin soaked gouge is to be put along with a layer of sterile cotton, and the whole is to be bandaged. Dressing is changed at least after 3 to 4 days or if it is soaked with the fluid, whichever is earlier. The progress of wound healing is to be monitored carefully. If a deeper injury is noticed earlier or observed subsequently where scar formation is likely, a skin grafting should be contemplated. The skin grafting will prevent future contracture to develop, give a neat healing and good cosmesis.
Prevention of scald is better than treatment.