Modern Plastic Surgery, 2011, 1, 1-2
doi:10.4236/mps.2011.11001 Published Online October 2011 (http://www.SciRP.org/journal/mps)
Burn Injury Due to Hot Water Bottle
Celalettin Sever1*, Yalcin Kulahci1, Fatih Uygur1, H us e yi n Kara g oz1, Yalcin Bayram2, Sinan Oksuz1,
Bilge Kagan Aysal1
1Department of Plastic and Reconstructive Surgery and Burn Unit, Gülhane Military Medical Academy and Medical Faculty, Haydar-
paşa Training Hospital, Istanbul, Turkey; 2Department of Plastic and Reconstructive Surgery, Maresal Cakmak Military Hospital, Erzu-
rum, Turkey.
Received September 15th, 2011; revised October 18th, 2011; accepted October 24th, 2011.
ABSTRACT
Hot water bottles, generally used to comfort and relief from aches and pains. We present a case of scald burn caused by
hot water bottle. The circumstances of this injury and preventive measures are discussed in this case report.
Keywords: Perianal Burn, Car Seat, Contact Burn, Gluteal Burn
1. Introduction
The hot water bottle is fabulous to use for relief of joint
discomfort, pains, muscular tension, stress or cramps,
aches, menstrual period pain and generally for the initial
heating of cold bedsheets [1]. The therapy effect of hot
water bottle has been known since the 16th century, and
it is still used today for many alternative medicine. Alth-
ough the hot water bottle offers comfort during the symp-
tomatic treatment of disorders, this therapy method has
scald burn injury risk for patient. To our knowledge, up to
now, despite its widespread use, only one burn injury have
been reported in the literature [1-3].
2. Case Report
We would like to report a case of a 27-year-old man who
suffered second and third degree burn to his posterior
side of trunk, right thigh and right gluteal region (Figure
1). The patient told us that he has lumbar disc herniation
and he was used hot water bottle to reveal severe back
pain. However, the patient suffered second and third de-
gree burn injury as the result of tear of hot water bottle
(Figure 2). Burn areas were dressed every day. Suitable
antibiotic therapy was begun with the consultation of the
infectious disease department. The burn area was treated
conservatively within six weeks without any surgery.
3. Discussion
Back pain has always been a problem for a number of
people; most of the people suffer from this condition at
some point of their life. Some patients when they suf-
fered from aches or pains don’t want to use the painkillers
or ointments to deal with them because of the side-effects
of drugs or allergic to their ingredients. In fact, allergies
to anti-inflammatory painkillers is far more common.
Figure 1. The second and third degree burn areas due to
tearing of hot water bottle.
Figure 2. The appearance of the teared hot water bottle.

Burn Injury Due to Hot Water Bottle
2
Heat is one of the best way to get relief from the pain.
They may be used for aches and pain, menstrual cramps.
Hot water bottles may be molded while sitting or lying
and in any position and provide heat to the area which,
alleviates the pain. Hot water bottles have been used for
centuries. Hot water bottles are large rubber bottles
“flattened” into an oval shape with a stopper on top that
may be removed to fill them with hot water. The earliest
hot water bottles were metal containers filled with hot
coals. Modern day, hot water bottles are manufactured in
rubber or similar material. The surface temperature of the
hot water bottle is maintained at maximum 50˚, accord-
ing to the manufacturers. Severe burns may also occur
slowly if a hot water bottle leave on one part of body for
more than 15 minutes [1-3].
These burns are preventable and therefore, some basic
measures may reduce the incidence of accidental burn
injury due to heated hot water bottles.
1) The hot water bottle manufacturers have to post
warnings in their owner’s manuals of the danger of po-
tential burns. The hot water bottles should be tested to
increase their safety.
2) The hot water bottle should be examined for any
damage, such as splits, holes or leaks before using. The
hot water bottles should not be filled with boiling water,
because boiling water may cause splits or leaks and will
shorten the life of the hot water bottle.
3) The hot water bottle should not be overfilled. Three
quarters is the maximum level to fill. A hot water bottle
gives out plenty of heat as well when filled to the correct
level.
4) The hot water bottles have to wrap in a towel to
prevent the bottle being in direct contact with the skin
especially for patients with sensory deficits.
5) The hot water bottle should exchange every one or
two years because the bottles which are in good con-
dition on the outside may be damaged on the inside.
6) The hot water bottle should only use to warm the
bed. The bottle should remove before get into bed and
empty it or place it out of reach. It should not use in a
bed fitted with an electric blanket. The patients should
not lean on, roll on, press against or lie on a hot water
bottle.
We hope that this case report will succeed in raising
awareness of the dangers involved in the hot water bot-
tles.
REFERENCES
[1] O. Lapid and S. Walfisch, “Gluteal Burns as a Complica-
tion of Hot Water Bottle Treatment for Anal Fissure,”
Burns, Vol. 25, No. 6, 1999, pp. 559-560.
doi:10.1016/S0305-4179(99)00030-3
[2] R. M. Jose, R. Vidyadharan, D. K. Roy, et al., “Hot Wa-
ter Bottles and Diabetic Patients—A Cautionary Tale,”
The British Journal of General Practice, Vol. 55, 2005,
pp. 222-223
[3] A. Whittam, A. Wilson and J. E. Greenwood, “Burn Inju-
ries Caused by Hot Water Bottles Audit and Loop Clo-
sure,” Eplasty, Vol. 10, 2010, p. e12.
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