Fire walking in Singapore—A study of the distribution of burns

Fire walking is a religious ritual practiced by predominantly Indians and some Chinese living in Singapore.Eighteen new cases of burns, directly related to a firewalking ceremony on 05 October 09, were studied as to the pattern of burns. Burns on the soles of the feet occurred in 17 patients. All these injuries were superficial or partial thickness burns. There were no deep dermal burns. The extent of burns ranged from 0.25% to 1.5% of body surface area. Burns due to falls accounted for one casualty. He sustained a mixture of deep dermal and partial thickness burns, and the extent of burns was 20% of body surface area.A new classification for the distribution of burns related to fire walking was developed based on the mechanism of injury. It was predictive of the anatomical distribution of burns, the extent of burns (in terms of body surface area), the depth of burns and the general severity of the injury:IBurns on the soles of the feet. This was the commonest form of injury. The surface area affected was not much – 1.5% at most. The burns were superficial. The foot was anatomically differentiated into the weight bearing and the non weight bearing parts.IIBurns due to falls. Such injuries tended to be extensive and they could be deep.IIIBurns due to other practices: a fire walker carrying hot coals in his hands may sustain burns on the palms of the hands.