Self-immolation after forehead flap

Background and aimAside from topical skin preparations and surgical drapes, the medical literature inadequately addresses the flammability risks associated with the use of other potential fuel sources. The flammability risk of petroleum-based topical ointments and wound dressings requires particular attention. The purpose of this case report is to highlight the potential risks associated with these products.MethodsClinical charts of adult patients who underwent facial reconstruction between 2007 and 2016 were retrospectively reviewed. Demographics, clinical information, and treatment outcomes were analyzed. The main outcome measure was self-inflicted burn injury secondary to ignition of facial wound dressing by a tobacco product. In addition, the MEDLINE, Cochrane, and PubMed databases were reviewed for articles published on the fire risk associated with petrolatum-based products.ResultsA total of 39 patients who underwent 40 forehead flaps for facial reconstruction were identified. A 5% incidence of self-inflicted burn injury secondary to ignition of a facial wound dressing by a tobacco product was found in our patient population.ConclusionsDespite the widespread use of petrolatum-based products and their role as potential fuel sources, the flammability potential of these products is poorly described in the literature. Nonetheless, petroleum-based products are associated with potential risks, especially for patients who smoke or for those who engage in activities or occupations that pose a greater risk for fire exposure. Surgeons must be explicit in communicating this risk to patients to prevent acutely devastating complications.