Rhabdomyolysis caused by hot air sauna burn |
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| Authors: | Koski Antti Koljonen Virve Vuola Jyrki |
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| Affiliation: | 1. Department of Surgery, University of South Carolina School of Medicine, Columbia, SC 29209, USA;2. Department of Surgery, University of North Carolina School of Medicine, 7038 Burnett-Womack, Campus Box 7195, Chapel Hill, NC 27599, USA;3. Alpert Medical School, Brown University, Providence, RI 02903, USA;4. Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA;1. Department of Anaesthesia and Intensive Care, Faculty of Medicine, University of Pécs, Hungary;2. Department of Surgical Research and Techniques, Faculty of Medicine, University of Pécs, Hungary;1. Department of Burns and Plastic Surgery, Chengdu Military General Hospital, China;2. Ganbu Ward, Chengdu Military General Hospital, China;1. Division of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland;2. University of Zurich, Switzerland;3. Department of Immunology, University Hospital Zurich, Switzerland;1. Burn Center of Imam Khomeini Teaching Hospital, Urmia University of Medical Sciences, Urmia, Iran;2. Patient Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran;3. School of Nursing and Midwifery, Urmia University of Medical Sciences, Urmia, Iran |
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| Abstract: | Sauna-related burns are rare, even in Finland where sauna bathing is a popular leisure pastime. Burns induced by hot air are even more rare and constitute a very small subgroup of all sauna burns. Hot air burns are characterised by a combination of full thickness skin damage with deep tissue destruction. We report here on six consecutive patients suffering from hot air sauna burns with rhabdomyolysis. All six patients were middle-aged, the majority of them men. Acute excessive consumption of alcohol exacerbated by a hot environment resulted in dehydration and loss of consciousness. Immobility and prolonged exposure to hot, dry air resulted in third degree regional burns with 5-32% TBSA. Rhabdomyolysis was evident on admission. The laboratory values of plasma creatine kinase (P-CK), plasma myoglobin (PM), blood pH, and serum potassium (S-K) during the first five days were evaluated. Aggressive fluid management and correction of acidosis and myoglobinuria were started on admission. Surgical management consisted of early, aggressive excision at fascial level, in some patients involving sacrifice of the upper layers of muscle. Even so, mortality in this small series was 50%. The best indicator of poor prognosis was a highly elevated CK value on the second post-injury day. |
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