Elsevier

Burns

Volume 36, Issue 5, August 2010, Pages e65-e67
Burns

Case report
Cryogenic burns from intentional use of aerosol spray in children: An emerging phenomenon

https://doi.org/10.1016/j.burns.2009.08.006Get rights and content

Introduction

Burns secondary to exposure to extremely low temperature mediums (cryogenic burns) are extremely uncommon. These injuries are almost universally associated with occupational exposure of adults to agents known to represent a hazard, such as liquid nitrogen or pressurised ammonia [1], [2], [3]. In recent years, however, three cases of cryogenic skin burns have been reported in children and adolescents after spraying with a commercially available aerosol can from a short distance [4], [5]. Camp et al. reported on two teenager girls who used an aerosol can of deodorant to achieve an “anaesthetic effect”, resulting in burns to their forearms and ankle [4]. Lacour et al. described an 8-year-old boy who sprayed his forearm with a toilet air freshener “for fun” [5]. Although all these injuries resulted from inappropriate use of commercially available aerosol propellants, these cases represent an isolated and sporadic phenomenon, where the mechanism of injury does not reflect a common pattern.

We report on seven patients that were recently treated at our hospital for the management of cryogenic burns from use of aerosol spray can. In all of our patients, the common mechanism of injury involved using an aerosol propellant in an attempt to produce superficial skin lesions well known as “frosties”. This is a popular activity amongst pre-adolescents and adolescents in South Australia.

Section snippets

Case report

Our retrospective review of patients referred for treatment to the Burns Unit, Adelaide Women's and Children's Hospital from January 2004 to April 2009 was approved by the Children Youth and Women's Health Service Research Ethics Committee (reference 201A 2007).

Five girls and two boys who sustained burns from non-accidental use of aerosol cans were treated over the four-year study period. Details relative to patients epidemiology, presentation, management, and outcome are summarised in Table 1.

Discussion

We report a series of seven paediatric patients who have suffered from cryogenic burns from the recreational use of an aerosol spray can. The burns observed in our series were particularly serious, most of them extending at least to the deep dermis. This may arise from a combination of different factors, including the severity of the initial injury, the universal lack of first aid, the delay in seeking medical advice following the burn, and the poor compliance to the recommended treatment and

Conclusions

The recreational use of aerosol spray to produce “frosties” is apparently an emerging phenomenon in pre-adolescents and adolescents in South Australia, which can result in cryogenic burns. Most of our patients presented with burns requiring a skin graft due both to the severity and underestimation of the initial lesions, and to poor compliance to treatment and follow-up. Two of the three cases previously reported in the literature resulted in severe burns requiring a skin graft [4], [5].

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