As romantic as the idea of wearing a ring sounds, this is the ring you don’t want!
Above is an image of a man’s finger having a blister secondary to burn after his wedding band got in contact with the terminal of the car battery and heated up, this is called a circumferential burn.
Overall, thermal ring injuries are a rare find in the medical literature. Metals used in the ring, be it gold, silver or platinum, conduct heat and electricity well enough to cause damage, although former two are better conductors than the latter. For cooks, it’s not unusual to have superficial burns due to heating up of their jewellery while cooking; even if it doesn’t burn, it surely generates a reflex to withdraw the hand when the ornament (rings, bangles, etc) heats up, you can relate if you are one! Similarly, some professionals such as mechanics and welders, have more incidence of electrothermal ring burns than others.
Usually such ring burns, due to the focused heat, can cause second-degree burns, but superficial ring burns have also been observed, therefore treatment options vary from simple cleaning on an outpatient basis to surgical options. Thus, no standard treatment has yet been outlined.
What do we mean by ‘degree of burn’??
These illustration explain the three degrees of burn:
What are the zones of injury? Is it important to be aware of the zones?
The 3 zones of burn injury are[ii]:
(1) zone of coagulation: Necrotic non-viable tissue, has to excised and possibly grafted.
(2)zones of stasis and (3) zone of edema/hyperemia: These two are the most critical zones as these two are dynamic i.e. can transform from viable to necrotic
The answer to the second part of the question is a big YES!
It is quite important to demarcate the zones of burn injury before taking any surgical measures as post-operatively if the digit becomes non-viable, it wouldn’t be possible to determine whether the initial injury is the culprit or the surgical consequences led to the nonviability. Nevertheless, the management approach can be debridement, primary closure of the wound, delayed closure, escharotomy in severe cases where the tissue has necrosed or graft/flap when the tendons get exposed. Whatever the approach be, it is essential to get immediate medical attention to prevent loss of the affected digit.
Food for thought:
For individuals whose profession revolves around electrical equipment, there is a need to vigorously emphasize upon the removal of all metal jewellery prior to contact. Since this is a health hazard, standard ergonomics should be promulgated.
REFERENCES:
2017; 9(1-3): 32–34. Published online 2018 Jul 17. DOI: 10.1016/j.jccw.2018.06.004
Andrade P, Kaura AS, Bryant JR, Burke E. Thermal Burn Injury from a Wedding Ring: An Unusual Case.
The Journal of the American College of Clinical Wound Specialists. 2017 ;9(1-3):32-34.
