Three cases were identified. The average burn TBSA was 8 %, ranging from 2 to 15 %. All patients had a mixture of partial- and full-thickness burns. The average length of stay was 9 days ranging from 1 to 16 days. Two patients required inpatient admission and surgery. All the patients were male and habitual e-cigarette users. The average age at time of injury was 29 years old.
Case 1
A 34-year-old male with a history of ulcerative colitis and opioid dependence had placed an electronic cigarette in his right pant pocket which spontaneously combusted while shopping in public. His pants caught fire and were immediately removed to extinguish flames. He was brought to the emergency department by an ambulance.
Examination revealed a 15 % TBSA circumferential deep partial-thickness and full-thickness burn of the right leg (Fig. 1). An epidural was placed for pain control, and on post-burn day 2, the patient was taken to the operating room for tangential excision with skin allograft placement to a 2000 cm2 surface area. The allografted areas were dressed with N-Terface (MEDLINE Industries, Inc., IL, USA) and ACTICOAT (Smith & Nephew, London, UK), and the debrided superficial partial-thickness burns were dressed with Mepilex Ag (Molnlycke, Gothenburg, Sweden). On post-burn day 6, the allograft was removed, revealing healthy subcutaneous tissue ready for skin autografting. Two thousand four hundred square centimeters of meshed split-thickness skin grafts were used to cover the wounds. The autografts showed an excellent take on post-burn day 9, and the patient was discharged home on post-burn day 16 (Figs. 2 and 3).
Case 2
A 19-year-old otherwise healthy male had an electronic cigarette in his left pant pocket when it combusted and lit his pants on fire. He immediately removed his pants and rolled on the ground, which extinguished the flames. He was brought to the emergency department by an ambulance.
Examination revealed a 7 % TBSA non-circumferential mixed partial- and full-thickness burn to the lateral thigh and calf (Fig. 4). On post-burn day 3, he was taken to the operating room for tangential excision and immediate split-thickness skin autografting of 800 cm2. The patient was discharged on post-burn day 9 with 100 % graft take and healing wounds (Fig. 5).
Case 3
A 35-year-old otherwise healthy male sustained a 2 % TBSA burn to his right lateral thigh when an e-cigarette device in the right back pocket of his pants spontaneously combusted, burning a hole through his pants (Fig. 6). Upon arrival to the emergency department, he was found to have partial- and full-thickness burns to his right thigh (Fig. 7). The patient was treated in the outpatient setting with topical wound care. The patient elected for non-operative treatment and healed in 5 weeks.