We report a case of an accidental burn from a self-applied heat pack following subcutaneous mastectomy and implant reconstruction. Such patients are at increased risk of accidental burns not only due to loss of protective sensation, but also because of the thinner, less vascular overlying skin. We have changed our practice so that all patients undergoing breast reconstructive surgery are warned postoperatively to protect the skin from externally applied heat sources.
Wounds to the pretibial region in the elderly are common and have been estimated to account for 5.2 per 1000 emergency department attendances.1 In this patient population, such an injury can precipitate a rapid decline in mobility and independence. Minimising the period of immobility associated with such an injury has been shown to reduce this effect.2 In many cases this is best achieved through early debridement and split skin-graft coverage. However, unacceptable delays often occur in the care pathway of these patients. This frequently leads to a considerably longer period of hospitalisation and immobility than is necessary.
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