Lithium ion button battery causing a full-thickness cutaneous burn while trapped under an occlusive burns dressing.

Ms Kelly  Wardell1, Dr Anthony Penna1, Dr  Tim T  Wang1, Dr  John Vandervord1, A/Prof Damian D Marucci1,2

1The Childrens Hospital Westmead,  Westmead , Australia, 2Department of Surgery, The University of Sydney, Camperdown, Australia


Introduction: Alkaline or lithium-ion button batteries can cause significant chemical burns in children who ingest or insert them into orifices. We present a rare and unusual case of a full thickness cutaneous burn related to a non-exploding Lithium ion button battery.

Case: A three-year-old male presented with a 5% TBSA oil scald burn to the neck and torso He underwent hydrosurgical debridement and application of an occlusive dressing. Dressing change on Day 13 revealed a lithium button battery under his dressings in direct contact with skin. This had caused a full thickness burn to the central chest with a significant circular cavity into the subcutaneous tissue. His burns were debrided and reconstructed with layered dermal matrix and split skin grafting.

Conclusion: Only a handful of cutaneous burns from button batteries exist in the literature. It is theorised that moist environments provide a conductive medium in which electrolysis and subsequent liquefactive necrosis of tissue can occur. Education regarding the potential for this injury is important. Battery redesign to prevent activation when not in a device may be beneficial.


This paper was authored through the Children’sHospital Westmead burns department. Kelly Wardell, a nurse practitioner from the unit will be presenting the case.

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