Rasam Burns

Burns is a common accident which can happen in our daily life. The superficial burn wound heals by secondary intention. Debridement and skin grafting is done for second degree to third degree burns. There will be delay in wound healing if the burns are deep and get infected. There are various causes of burns. Recently we came across a common yet under reported cause of burns in the southern part of India due to ‘Rasam’ which is a hot spicy liquid (soup) commonly used as food item. This study is the first study reported in the world in which ‘Rasam’ is declared as one of the cause of burns. We called it ‘Rasam Burns’.

Injuries remain the leading cause of pediatric mortality, and burns are the fourth most common mechanism of injury, Younger children more commonly present with scald burns; whereas, flame burns are seen more often in adolescents. Burns is a common accident which can happen in our daily life. The superficial burn wound heals by secondary intention. Debridement and skin grafting is done for second degree to third degree burns. There will be delay in wound healing if the burns are deep and get infected [1]. There are various causes of burns. Recently we came across a common yet under reported cause of burns in the southern part of India due to ‘Rasam’ which is a hot spicy liquid (soup) commonly used as food item. The word Rasam means ‘juice’ in tamil and telugu language. Rasam is a soup made from boiling water with different spices condiments with oil in southern India as traditional meal. It tastes slightly tangy, saury & flavourful from cumin, pepper powder and garlic. It is boiled before serving. If accidently falls then it leads to scalds burn injuries. Due to presence of spices the victim develops severe burning and itching other than the pain due to hot liquid. The burns healing may be delayed due to presence of its ingredients. The severity of the burns depends on temperature and contact period of hot liquid. On searching open access sources,this study is first time being reported in which ‘Rasam’ is declared as one of the cause of burns. We called it as ‘Rasam Burns’ [2].

The study was conducted in the department of plastic surgery in a tertiary care hospital. Informed consent was obtained from the subject under study. Scientific and ethical approval was taken from department scientific and ethical committee. The patient being reported was a 7 year female child who had history of accidental spillage of hot rasam on her while playing in the kitchen involving the chest, abdomen, axilla, left upper arm and forearm amounting to a total of about 20 % mixed 2^nd degree and 3^rd degree deep burns (Figure 1). Patient complains of severe burning, itching and pain. The patient was admitted and treated initially with intra venous fluids and sterile dressing. After 48 hours tangential excision and skin grafting was done (Figure 2).

Postoperative there was satisfactory graft take. Patient was discharged with no complications.

Figure 1: Burn injuries due to rasam.

Figure 2: After tangential excision and skin grafting.

The World Health Organization (WHO) reported 1, 80,000 deaths annually due to burn injury majority of which are contributed by low and middle-income countries where the resources are limited [3]. Even though advancements in burn injury management have significantly reduced the burn mortality, due to limited resources burn mortality is still high in developing countries. Treatment of burn wounds has always proved challenging in the paediatric population. When treating large surface area or complex burn wounds, paediatric patients frequently have limited area of graft donor sites. Advancements in burn management over the years have significantly decreased burn mortality. However, higher death rates are still a glaring issue in developing countries where these advancements are yet to be recognised and implemented. Infants often have skin too thin to be harvested for skin grafting and to provide adequate coverage for reconstruction. Burn injury is a major cause of trauma to the human body, with an extended wound healing period. The mortality rate of burn injury has decreased with new treatment modalities, but prolonged healing periods still affect the morbidity rates. Electric burns cause both mortality and morbidity and can have varying effects on the body. The wounds are difficult to heal and may need added methods to facilitate healing. Many therapeutic methods are available to promote the wound healing such as the topical application of insulin, growth factors, negative pressure assisted wound closure, oxidized regenerated cellulose/collagen, hyaluronic acid conjugated with glycidyl methacrylate or gelatine dressings.

This is the first case report on another cause of burns called as ‘Rasam Burns’. One should be aware of this type of scald burn injury & manage accordingly.

1. Gonzalez R, Shanti CM. Overview of current pediatric burn care. Semin Pediatr Surg. 2015; 24: 47- 49.
2. Martinez-Zapata MJ, Marti-Carvajal A, Sola I, Bolibar I, Exposito JA, Rodriguez L, et al. Efficacy and safety of the use of autologous plasma rich in platelets for tissue regeneration: a systematic review. Transfusion. 2009; 49: 44-56.
3. Noor DM, Wicaksana A, Fauzi AR, Seswandhana R. Comparison between revised Baux score and abbreviated burn severity index as a predictor of mortality in burn patients at a tertiary care centre in Yogyakarta, Indonesia. Eur J Plast Surg. 2020; 43: 53-58.