Comprehensive Management of Facial Burns from Boiler Explosion: Case Report

Abstract

A 22-year-old male patient suffered an extensive facial burn after the accidental explosion of a domestic boiler. The burn involved the forehead, eyelids, nose, cheeks, lips, and chin, representing approximately 18% of total body surface area. On admission, he presented with severe pain, significant periorbital edema, and progressive airway compromise, necessitating endotracheal intubation and intensive care monitoring. Initial management included hemodynamic stabilization, fluid resuscitation according to the Parkland formula, analgesia, and infection prophylaxis. Multiple surgical debridements were performed to remove necrotic tissue and prepare the wound bed. Subsequently, Suprathel®, a biosynthetic, biodegradable polylactide-based dressing, was applied to promote reepithelialization, reduce pain, prevent infection, and enhance dermal regeneration. The patient’s evolution was favorable, with gradual reduction of edema, complete wound coverage, preservation of facial function including eyelid closure and oral competence, and minimal residual hyperpigmentation. No additional skin grafts were required. This case highlights the importance of an integrated approach to severe facial burns, combining early airway management, critical care support, surgical debridement, and advanced wound coverage with biosynthetic dressings. The use of Suprathel® demonstrates significant benefits in functional and aesthetic outcomes, pain reduction, and accelerated healing, emphasizing its role as a modern standard in the management of complex facial burns.