Successful Debridement and Collagen Application for 8% Mixed Scald Burns in a 29 Y.O. Female

Chief Complaints

A 29-year-old female patient with a body mass index (BMI) of 21 presented to the Plastic and Reconstructive Surgery Department at PACE Hospitals, Hitech City, Hyderabad, with complaints of scald burns over the left side of the neck, breast, upper chest, and back. The patient reported a history of accidental scald burns sustained while taking steam from hot water.

The patient had no known medical illnesses, had not undergone any previous surgeries, and had no known allergies. She had otherwise been healthy prior to sustaining the burn injury.

On examination, the patient was conscious, coherent, and cooperative. There were no signs of pallor, icterus, cyanosis, clubbing, lymphadenopathy, or pedal edema. The general physical examination was otherwise normal, and the patient was hemodynamically stable at the time of assessment.

Upon admission to PACE Hospitals, following the clinical examination, the Plastic Surgery team conducted a detailed assessment of the patient’s complaints of accidental scald burns involving the left side of the neck, breast, upper chest, and back sustained while taking steam from hot water. A focused evaluation of the affected areas revealed that they were superficial to partial thickness burn injuries covering approximately 8% total body surface area, consistent with mixed scald burns.

Considering the acute thermal injury, a comprehensive clinical and laboratory evaluation was performed to assess the extent of tissue damage and to rule out systemic involvement or associated complications. Laboratory investigations, including complete blood count, renal function tests, coagulation profile, and viral screening, were within acceptable limits for surgical intervention. Chest radiography showed no evidence of thoracic injury or pulmonary involvement.

Based on the confirmed diagnosis, the patient was advised to undergo Scald Burns Treatment in Hyderabad, India, for burns involving the left side of the neck, breast, upper chest, and back, to aid healing and prevent infection under the care of the Plastic and Reconstructive Surgery team.

After a thorough evaluation by Dr. Kantamneni Lakshmi, (Senior Consultant Plastic, Reconstructive & Aesthetic Surgeon), a comprehensive assessment was carried out to determine the most appropriate management plan for the patient presenting with 8% mixed scald burns involving the left side of the neck, breast, upper chest, and back following accidental exposure to hot steam.

Based on the clinical findings of superficial to partial thickness thermal injuries with blister formation and devitalized skin, it was determined that early surgical intervention was required to promote wound healing, prevent infection, and remove non-viable tissue. Accordingly, the patient was planned for surgical debridement with collagen application under general anaesthesia, following stabilization and completion of routine preoperative investigations.

The patient was also evaluated with complete laboratory workup, including hematological, renal, coagulation, and viral screening, which revealed no contraindications for surgery and confirmed fitness for anaesthesia. Chest radiography was normal, with no evidence of systemic or thoracic involvement. Based on these findings, the patient was deemed fit for surgical management.

The patient and her family were counselled regarding the nature of the burn injury, need for debridement, benefits of collagen dressing, expected healing course, and importance of postoperative wound care, infection prevention, medication adherence, and regular follow-up to ensure optimal recovery and scar management.

Following the diagnosis, the patient was scheduled to undergo Debridement and Collagen Application Procedure in Hyderabad at PACE Hospitals, under the supervision of the expert Plastic and Reconstructive Surgery team.

The surgical procedure involved the following steps:

• Anaesthesia and Patient Preparation: The patient was taken to the operating room and placed under general anaesthesia (G.A.). The burn areas involving the left side of the neck, breast, upper chest, and back were thoroughly assessed. The skin was then painted with antiseptic solution and draped under strict aseptic conditions to maintain a sterile operative field.

• Wound Assessment and Exposure: All burn areas were carefully exposed and examined to assess the depth and extent of injury. The presence of blisters, necrotic tissue, and devitalized skin was noted over the affected regions.

• Debridement of Burn Wounds: Surgical debridement was performed by carefully removing all blisters and non-viable (dead) tissue. This step ensured clearance of contaminated and devitalized tissue to promote healthy granulation and reduce risk of infection.

• Wound Irrigation: After debridement, the wound bed was thoroughly irrigated with sterile normal saline to remove debris, reduce bacterial load, and ensure a clean wound surface suitable for dressing application.

• Collagen Dressing Application and Completion: A wet collagen dressing was applied evenly over the cleaned wound surface and allowed to dry in place. The dressing was secured appropriately to support wound healing, maintain moisture balance, and enhance tissue regeneration. The procedure was completed uneventfully, and the patient was shifted out of the operating room in stable condition.

Postoperatively, the patient remained stable with an uneventful recovery. The wound was clean, and the collagen dressing was intact with no signs of infection or fluid collection. The patient received infection prevention therapy, pain control, gastric protection, tetanus prophylaxis, and respiratory support as part of routine postoperative care. She was discharged in stable condition with advice for continued wound care and follow-up.

Upon discharge, the patient was prescribed oral therapy for prevention of wound infection, effective pain control, gastric protection, and nutritional supplementation to support tissue healing and recovery. The medications were advised for a short duration to ensure continued stability, promote optimal burn wound healing, and prevent postoperative complications.

The patient was informed to contact the emergency ward at PACE Hospitals in case of any emergency or development of symptoms such as fever, increasing pain, redness, swelling, or any wound discharge.

The patient was advised to return for a follow-up consultation with the Consultant Plastic, Reconstructive & Aesthetic Surgeon in Hyderabad at PACE Hospitals after 2 days.

This case highlights an 8% mixed scald burn involving the left side of the neck, breast, upper chest, and back due to accidental hot steam exposure. The patient was managed with surgical debridement and collagen application under general anaesthesia. Postoperative recovery was uneventful with stable clinical and laboratory parameters. The patient was discharged in stable condition with proper wound care and follow-up advice.

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