Genital burns caused by cell phone combustion following a motorcycle accident: a case report

Genital burns caused by cell phone combustion following a motorcycle accident: a case report | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Genital burns caused by cell phone combustion following a motorcycle accident: a case report Koshi Ota, Saki Mizutani, Akinori Asaka, Yuri Yae, Kanna Ota, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7239351/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 06 Oct, 2025 Read the published version in International Journal of Emergency Medicine → Version 1 posted 16 You are reading this latest preprint version Abstract Background Thermal injuries are common in emergency departments, but rarely involve isolated genital burns. However, burns caused by electronic devices, particularly cell phones, represent an emerging concern. Case Presentation: A 47-year-old man presented with third-degree burns to the left anterior thigh, penis, and scrotum, covering 2% of the total body surface area, accompanied by facial fractures. These injuries had been sustained in a collision. A burned cell phone was discovered in clothing adjacent to the perineum, leading to the suspicion that it had ignited in his trouser pocket, causing burns in addition to trauma from the collision. He underwent surgical debridement and split-thickness skin grafting on hospital day 14. Despite the severity of the injury, the patient achieved complete epithelialization and recovered pre-injury urological and sexual function by the 3-month follow-up. To our knowledge, this represents the first report of deep dermal and full-thickness genital burns caused by cell phone combustion. Conclusions This case highlights the potential for severe thermal injuries from cell phones, possibly exacerbated by trauma, and underscores the importance of patient education regarding the safe handling and storage of cell phones, particularly during activities like cycling or motorcycling. cell phone genital burns deep dermal burn full-thickness (third-degree) burn Figures Figure 1 Figure 2 Figure 3 Figure 4 Background Thermal injuries are a common presentation in emergency departments, frequently resulting from contact with hot liquids, flames, chemical agents, and electrical sources. 1 While less common, burns caused by electronic devices, particularly cell phones, are an emerging concern due to their widespread use and close proximity to the body. 2 , 3 Such incidents typically relate to battery malfunction or overheating. 2 , 3 Isolated genital burns are rare, likely reflecting the relatively protected location of the genitalia from common burn insults. 4 We report a unique case of severe genital burns resulting from cell phone combustion during a traffic accident, affecting an area with significant functional and psychological implications. Case Presentation A 47-year-old man presented to the emergency department approximately 30 min after being involved in a motorcycle accident. He reported sustaining injuries when his motorcycle, traveling at approximately 40 km/h, collided with a parked car due to inattentive riding. He called an ambulance after experiencing bilateral epistaxis and upper limb pain. He further reported that his cell phone (brand and model unknown, but described as a smartphone less than 1 year old) had suddenly ignited while in the left front pocket of his trousers. He immediately felt intense heat and pain in his groin area. Upon removing the trousers, he observed flames and smoke emanating from the phone and a developing burn on his skin, which was extinguished spontaneously (Fig. 1 A–C). Upon arrival, vital signs were as follows: temperature, 36.6°C; heart rate, 65 beats/min with regular rhythm; respiratory rate, 18 breaths/min; blood pressure, 141/99 mmHg; and oxygen saturation, 100% on room air. Glasgow Coma Scale (GCS) score on arrival was 15 (E4V5M6). Physical examination revealed active bilateral epistaxis (Fig. 2 A). Deep dermal burns and full-thickness (third-degree) burns were estimated to cover 2% of the total body surface area (TBSA), involving the left anterior thigh and extending to the penis and scrotum (Fig. 1 A–C). The affected skin was charred, with loss of sensation to light touch, and demonstrated coagulative necrosis. No active bleeding or blistering was observed on the burn area at the time of presentation. The patient did not report pain related to his facial injuries or the perineal burn. The remainder of the physical examination was unremarkable, except for right elbow pain upon bending. The patient reported no significant past medical history or allergies. Management and Outcome The patient received immediate first aid, including insertion of a urinary catheter and application of sterile dressings. Intravenous fluid resuscitation was initiated and broad-spectrum antibiotics were administered. Computed tomography (CT) revealed multiple facial fractures, specifically involving the anterior wall of the frontal bone, the nasal bone, and a Le Fort I fracture (Fig. 2 B). Whole-body CT did not show any other traumatic changes. Due to the full-thickness nature of the burns and the involvement of a sensitive location, surgical debridement and skin grafting were deemed necessary. Topical application of bromelain ointment was initiated on the day after admission. Under general anesthesia, necrotic tissue was excised on day 14 after admission. The thigh burn was amenable to primary closure. After undermining, the wound was approximated using 3 − 0 polydioxanone sutures for the subcutaneous tissue, 4 − 0 polydioxanone sutures for the dermis, and 5 − 0 Nylon for the epidermis. A split-thickness skin graft (STSG) was harvested from the left thigh and meticulously applied to the debrided areas of the scrotum and penis. On the left side of the scrotum, a dermal substitute (PerNac®; Bear Medic Co., Tokyo, Japan) was secured to prevent adhesion. After applying antiseptic gauze dressing, the penis and glans were surrounded with cotton, and the penis was elevated and secured with a paper cup. The same day, the facial fractures were also operated on with titanium plate fixation. Postoperatively, the patient received cefazolin and daily wound care. Pain was managed with opioid analgesics on the day of the operation, but the patient reported no pain the next day and did not require further analgesics (Fig. 3 ). The skin graft proved successful. The urethral catheter was removed on day 22 post-admission. The patient was discharged on day 28 post-admission with instructions for continued wound care and follow-up. At the 3-month follow-up, the graft remained viable and the patient had regained full range of motion in the left hip. He reported no residual discomfort or altered sensation in the grafted area and was able to resume normal daily activities. Scarring was evident, but functional outcomes were good (Fig. 4 ). Urological and sexual function had recovered to pre-injury states. The patient did not attend the 7-month follow-up appointment. Discussion To the best of our knowledge, this represents the first report of deep dermal and full-thickness genital burns resulting from cell phone combustion. Cell phones are ubiquitous and indispensable devices in daily life, and cell phone-related injuries are thus increasing. 2 , 3 , 5 Thermal injuries due to cell phone combustion may continue to rise, but genital burns specifically from this cause have not been reported previously. Fortunately, despite sustaining full-thickness (third-degree) burns to the genitals, the patient achieved recovery of urological and sexual functions to the pre-injury states. Cell phones contain lithium-ion batteries that can accidentally overheat or explode. The injuries in this case might be attributed to ignition of the lithium battery in the cell phone following physical damage in the motorcycle accident. While ignition might not have occurred without the accident, lithium-ion batteries comprise a cathode and anode separated by an insulating membrane known as a separator. If this separator is damaged due to significant mechanical impact, thermal runaway can occur, potentially leading to combustion. 6 We therefore recommend that cyclists or motorcyclists avoid placing their cell phones in their pockets while riding. The genitalia alone comprise about 1% of the TBSA, but this location is of immense functional, anatomical and psychological relevance. 7 Previous studies have revealed that genital and perineal burns can significantly impact patient morbidity, with potential long-term sequelae such as scar contracture and urethral stenosis. 8 , 9 While genital burns are commonly associated with major burns, the exact incidence of isolated genital burns is unknown, but may be less than 5% of all genital burns. 7 A previous case of left thigh burn due to a cell phone battery overheating involved a second-degree burn that was managed with daily self-dressing. 2 In our case, the patient suffered from both genital and left thigh burns due to cell phone combustion following a motorcycle accident. Although the total burn area was at most 2%, most was a full-thickness (third-degree) burn, necessitating surgical intervention. Urethral catheterization is generally not recommended as a standard treatment for genital burns and remains a topic of much discussion, given the risks of urinary tract colonization and harm to the urethra and bowel. 7 , 10 However, we continued urethral catheter management to stent the urethra. After removing the urethral catheter, the patient was able to urinate spontaneously and no longer required fluid management. Generous conservative treatment is often employed for most cases of second-degree genital and perineal burns. 10 Conservative wound treatment after burn injury is frequently recommended for children, with surgical treatment and STSG reserved for severe burns, as children generally have better healing capacity than adults. 10 The treatment of deep dermal and full-thickness genital burns is much more challenging. In the present case, we waited for demarcation of the burn wound with enzymatic debridement based on bromelain, and tangential debridement was performed with a scalpel and curette until bleeding was observed on day 14 post-admission. A previous study recommended full-thickness skin grafts for reconstruction of the penile shaft, since debilitating inelastic and painful hypertrophic scarring was less likely compared with STSG. 10 However, we chose STSG because the penile burn was not circumferential, the post-surgical course was uneventful and the patient was able to resume normal daily activities. Conclusions We have presented a case of deep dermal and full-thickness genital burns resulting from cell phone combustion. The ignition of the lithium battery in the cell phone was likely attributable to the motorcycle accident. Given that cellular phones are currently a lithium battery-dependent technology, we recommend avoiding placing cell phones in pockets when engaging in strenuous activities to prevent potential burn injuries. Declarations Ethics approval and consent to participate: not applicable. Consent for publication: The patient provided written, informed consent for publication of the details of this case. Consent to Participate declaration: not applicable Funding: No funding was received for the study. Additional Information Author Contributions All authors have reviewed the final version to be published and agreed to be accountable for all aspects of the work. Concept and design: Koshi Ota Acquisition, analysis, or interpretation of data: Koshi Ota, Saki Mizutani, Kanna Ota Drafting of the manuscript: Koshi Ota, Saki Mizutani, Kanna Ota, Akira Takasu Critical review of the manuscript for important intellectual content: Koshi Ota, Saki Mizutani, Kanna Ota, Akinori Asaka, Yuri Yae, Akira Takasu Supervision: Akira Takasu, Takashi Nuri Disclosures Informed Consent: The patient provided written, informed consent for publication of the details of this case. Conflicts of Interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work. References Yoshino Y, Ohtsuka M, Kawaguchi M, et al. The wound/burn guidelines – 6: Guidelines for the management of burns. Journal of Dermatology . 2016;43(9):989-1010. doi:10.1111/1346-8138.13288 Mankowski PJ, Kanevsky J, Bakirtzian P, Cugno S. Cellular phone collateral damage: A review of burns associated with lithium battery powered mobile devices. Burns . 2016;42(4):e61-e64. doi:10.1016/j.burns.2015.10.012 Povolotskiy R, Gupta N, Leverant AB, Kandinov A, Paskhover B. Head and Neck Injuries Associated with Cell Phone Use. JAMA Otolaryngol Head Neck Surg . 2020;146(2):122-127. doi:10.1001/jamaoto.2019.3678 Harpole BG, Wibbenmeyer LA, Erickson BA. Genital burns in the national burn repository: Incidence, etiology, and impact on morbidity and mortality. Urology . 2014;83(2):298-303. doi:10.1016/j.urology.2013.10.039 Smith DC, Schreiber KM, Saltos A, Lichenstein SB, Lichenstein R. Ambulatory cell phone injuries in the United States: An emerging national concern. J Safety Res . 2013;47:19-23. doi:10.1016/j.jsr.2013.08.003 Liu Z, Jiang Y, Hu Q, et al. Safer Lithium-Ion Batteries from the Separator Aspect: Development and Future Perspectives. Energy and Environmental Materials . 2021;4(3):336-362. doi:10.1002/eem2.12129 Baba PUF, Shah RA, Rasool A, Kaul A, Wani AH. Perineal burns: Epidemiology, severity factors, management issues and outcome. Burns Open . 2022;6(2):97-104. doi:10.1016/j.burnso.2022.03.003 Bonaventura B, Panayi AC, Hummedah K, et al. Outcomes in patients with burns to the perineum, buttocks and genitalia: A retrospective cohort study. Burns . 2024;50(3):767-773. doi:10.1016/j.burns.2023.10.003 Dovirak I, Arbel EJ, Reese AD, et al. Genital burn injuries: Insights from 10 years of consumer product-related incidents. Burns . 2025;51(5). doi:10.1016/j.burns.2025.107457 Schulz A, Ribitsch B, Fuchs PC, Lipensky A, Schiefer JL. Treatment of Genital Burn Injuries: Traditional Procedures and New Techniques. Adv Skin Wound Care . 2018;31(7):314-321. doi:10.1097/01.ASW.0000532474.34841.d0 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 06 Oct, 2025 Read the published version in International Journal of Emergency Medicine → Version 1 posted Editorial decision: Revision requested 26 Aug, 2025 Reviewers agreed at journal 26 Aug, 2025 Reviewers agreed at journal 24 Aug, 2025 Reviews received at journal 23 Aug, 2025 Reviews received at journal 22 Aug, 2025 Reviews received at journal 21 Aug, 2025 Reviewers agreed at journal 21 Aug, 2025 Reviewers agreed at journal 21 Aug, 2025 Reviewers agreed at journal 21 Aug, 2025 Reviewers agreed at journal 20 Aug, 2025 Reviewers agreed at journal 19 Aug, 2025 Reviewers agreed at journal 19 Aug, 2025 Reviewers invited by journal 19 Aug, 2025 Editor assigned by journal 08 Aug, 2025 Submission checks completed at journal 08 Aug, 2025 First submitted to journal 29 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7239351","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":506075547,"identity":"1fac73c5-1428-47d1-92ff-838ccc4c63fb","order_by":0,"name":"Koshi Ota","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYBACCQYGNoYEEIu9AS6YQJQWCQaeA6RoAdMS+BUigGR7+7MHDxhs6vhnPj66ubCNQZ6/geHZA3xapHnOmBskMKRJSNxOS7s9s43BcMYBhnQDfFrkJHLYgE46LMFwO8fsNm8bA+MGBqAB+LWkPwNrkb95BqzFnqAWaYkEM7AWgxs8YC2JBLVI9pwBajFIk9x4BuiXGeckkmccJuAXiePtzyR/VNjwyx0/fOx2QZmNbX97T9oDfFogAGoqMziemHnSCOuAAWYIxX6MeC2jYBSMglEwEgAAw0VCBHtsi5oAAAAASUVORK5CYII=","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":true,"prefix":"","firstName":"Koshi","middleName":"","lastName":"Ota","suffix":""},{"id":506075548,"identity":"a1b2d8f5-bdef-4b6b-acad-fbea43df6e81","order_by":1,"name":"Saki Mizutani","email":"","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":false,"prefix":"","firstName":"Saki","middleName":"","lastName":"Mizutani","suffix":""},{"id":506075551,"identity":"7583984e-6869-443a-8d37-6a7fa4439fab","order_by":2,"name":"Akinori Asaka","email":"","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":false,"prefix":"","firstName":"Akinori","middleName":"","lastName":"Asaka","suffix":""},{"id":506075552,"identity":"44e631a9-e461-4cef-8b43-aa15aef5ffb6","order_by":3,"name":"Yuri Yae","email":"","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":false,"prefix":"","firstName":"Yuri","middleName":"","lastName":"Yae","suffix":""},{"id":506075553,"identity":"e651e91a-6fc8-49fb-8941-20fcc618f46a","order_by":4,"name":"Kanna Ota","email":"","orcid":"","institution":"Osaka Healthcare Clinic","correspondingAuthor":false,"prefix":"","firstName":"Kanna","middleName":"","lastName":"Ota","suffix":""},{"id":506075555,"identity":"67a10a81-c619-4e6e-86c6-9940ad15425e","order_by":5,"name":"Takashi Nuri","email":"","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":false,"prefix":"","firstName":"Takashi","middleName":"","lastName":"Nuri","suffix":""},{"id":506075557,"identity":"2132ea48-9c1b-47b3-831b-47121625c835","order_by":6,"name":"Akira Takasu","email":"","orcid":"","institution":"Osaka Medical and Pharmaceutical University","correspondingAuthor":false,"prefix":"","firstName":"Akira","middleName":"","lastName":"Takasu","suffix":""}],"badges":[],"createdAt":"2025-07-29 05:53:09","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7239351/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7239351/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12245-025-01002-2","type":"published","date":"2025-10-06T15:58:27+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90301305,"identity":"06b02392-29b7-4906-8048-359cba0be2b2","added_by":"auto","created_at":"2025-09-01 08:58:26","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":836810,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA)\u003c/strong\u003e Clinical photograph on arrival at the emergency department, showing deep dermal and full-thickness (third-degree) burns, estimated to cover 2% of the total body surface area, involving the left anterior thigh and extending to the penis and scrotum. \u003cstrong\u003eB,\u003c/strong\u003e \u003cstrong\u003eC)\u003c/strong\u003e The burnt cell phone found in the left pocket of the trousers. The cell phone is completely adherent to the trousers.\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-7239351/v1/f6f9f0496ec41d8a524790cd.png"},{"id":90302166,"identity":"195a62d8-608f-4f8c-b07c-2b752252ea30","added_by":"auto","created_at":"2025-09-01 09:06:26","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":611546,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA)\u003c/strong\u003e Clinical photograph showing active bilateral epistaxis upon arrival at the emergency department. \u003cstrong\u003eB)\u003c/strong\u003e Three-dimensional computed tomography of the skull. Arrows indicate fractures of the skull.\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-7239351/v1/ce0d2a6f32fdc18f2f024d17.png"},{"id":90301310,"identity":"1a98245f-b5d3-4319-9cbe-f1a2def84695","added_by":"auto","created_at":"2025-09-01 08:58:26","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":721043,"visible":true,"origin":"","legend":"\u003cp\u003eClinical photographs the day after the operation. \u003cstrong\u003eA)\u003c/strong\u003e A dermal substitute (PerNac®; Bear Medic Co., Tokyo, Japan) is secured to the left side of the scrotum to prevent adhesion. A split-thickness skin graft harvested from the left thigh is meticulously applied to debrided areas of the scrotum and penis. \u003cstrong\u003eB)\u003c/strong\u003e The penis is elevated and secured with a paper cup. The burn on the left thigh is amenable to primary closure, with approximation of the epidermis using 5-0 Nylon sutures.\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-7239351/v1/21370e496f8b1b36a3b23540.png"},{"id":90301311,"identity":"5a8bfbba-3b34-460d-b039-708c34b50d10","added_by":"auto","created_at":"2025-09-01 08:58:27","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":697875,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eA)\u003c/strong\u003e Clinical photograph at the 3-month follow-up. The skin graft on the penis and scrotum remains viable, and scarring is less noticeable. \u003cstrong\u003eB)\u003c/strong\u003e The donor site on the left thigh is also less conspicuous. However, the primarily closed wound on the left thigh shows some scarring.\u003c/p\u003e","description":"","filename":"floatimage4.png","url":"https://assets-eu.researchsquare.com/files/rs-7239351/v1/b389e7da3311ebe855ceec82.png"},{"id":93419977,"identity":"11608399-80be-4c4c-936d-03c46ff118cb","added_by":"auto","created_at":"2025-10-13 16:09:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":3220154,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7239351/v1/a19564a0-f65b-410e-b790-207e455874c8.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Genital burns caused by cell phone combustion following a motorcycle accident: a case report","fulltext":[{"header":"Background","content":"\u003cp\u003eThermal injuries are a common presentation in emergency departments, frequently resulting from contact with hot liquids, flames, chemical agents, and electrical sources.\u003csup\u003e\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e\u003c/sup\u003e While less common, burns caused by electronic devices, particularly cell phones, are an emerging concern due to their widespread use and close proximity to the body.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e Such incidents typically relate to battery malfunction or overheating.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u003c/sup\u003e\u003c/p\u003e\u003cp\u003eIsolated genital burns are rare, likely reflecting the relatively protected location of the genitalia from common burn insults.\u003csup\u003e\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u003c/sup\u003e We report a unique case of severe genital burns resulting from cell phone combustion during a traffic accident, affecting an area with significant functional and psychological implications.\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eA 47-year-old man presented to the emergency department approximately 30 min after being involved in a motorcycle accident. He reported sustaining injuries when his motorcycle, traveling at approximately 40 km/h, collided with a parked car due to inattentive riding. He called an ambulance after experiencing bilateral epistaxis and upper limb pain. He further reported that his cell phone (brand and model unknown, but described as a smartphone less than 1 year old) had suddenly ignited while in the left front pocket of his trousers. He immediately felt intense heat and pain in his groin area. Upon removing the trousers, he observed flames and smoke emanating from the phone and a developing burn on his skin, which was extinguished spontaneously (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA–C).\u003c/p\u003e\u003cp\u003eUpon arrival, vital signs were as follows: temperature, 36.6°C; heart rate, 65 beats/min with regular rhythm; respiratory rate, 18 breaths/min; blood pressure, 141/99 mmHg; and oxygen saturation, 100% on room air. Glasgow Coma Scale (GCS) score on arrival was 15 (E4V5M6).\u003c/p\u003e\u003cp\u003ePhysical examination revealed active bilateral epistaxis (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eA). Deep dermal burns and full-thickness (third-degree) burns were estimated to cover 2% of the total body surface area (TBSA), involving the left anterior thigh and extending to the penis and scrotum (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003eA–C). The affected skin was charred, with loss of sensation to light touch, and demonstrated coagulative necrosis. No active bleeding or blistering was observed on the burn area at the time of presentation. The patient did not report pain related to his facial injuries or the perineal burn. The remainder of the physical examination was unremarkable, except for right elbow pain upon bending. The patient reported no significant past medical history or allergies.\u003c/p\u003e\u003cp\u003e\u003cb\u003eManagement and Outcome\u003c/b\u003e\u003c/p\u003e\u003cp\u003eThe patient received immediate first aid, including insertion of a urinary catheter and application of sterile dressings. Intravenous fluid resuscitation was initiated and broad-spectrum antibiotics were administered. Computed tomography (CT) revealed multiple facial fractures, specifically involving the anterior wall of the frontal bone, the nasal bone, and a Le Fort I fracture (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003eB). Whole-body CT did not show any other traumatic changes. Due to the full-thickness nature of the burns and the involvement of a sensitive location, surgical debridement and skin grafting were deemed necessary. Topical application of bromelain ointment was initiated on the day after admission.\u003c/p\u003e\u003cp\u003eUnder general anesthesia, necrotic tissue was excised on day 14 after admission. The thigh burn was amenable to primary closure. After undermining, the wound was approximated using 3 − 0 polydioxanone sutures for the subcutaneous tissue, 4 − 0 polydioxanone sutures for the dermis, and 5 − 0 Nylon for the epidermis. A split-thickness skin graft (STSG) was harvested from the left thigh and meticulously applied to the debrided areas of the scrotum and penis. On the left side of the scrotum, a dermal substitute (PerNac®; Bear Medic Co., Tokyo, Japan) was secured to prevent adhesion. After applying antiseptic gauze dressing, the penis and glans were surrounded with cotton, and the penis was elevated and secured with a paper cup. The same day, the facial fractures were also operated on with titanium plate fixation. Postoperatively, the patient received cefazolin and daily wound care. Pain was managed with opioid analgesics on the day of the operation, but the patient reported no pain the next day and did not require further analgesics (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe skin graft proved successful. The urethral catheter was removed on day 22 post-admission. The patient was discharged on day 28 post-admission with instructions for continued wound care and follow-up. At the 3-month follow-up, the graft remained viable and the patient had regained full range of motion in the left hip. He reported no residual discomfort or altered sensation in the grafted area and was able to resume normal daily activities. Scarring was evident, but functional outcomes were good (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Urological and sexual function had recovered to pre-injury states. The patient did not attend the 7-month follow-up appointment.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eTo the best of our knowledge, this represents the first report of deep dermal and full-thickness genital burns resulting from cell phone combustion. Cell phones are ubiquitous and indispensable devices in daily life, and cell phone-related injuries are thus increasing.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e,\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e,\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e\u003c/sup\u003e Thermal injuries due to cell phone combustion may continue to rise, but genital burns specifically from this cause have not been reported previously. Fortunately, despite sustaining full-thickness (third-degree) burns to the genitals, the patient achieved recovery of urological and sexual functions to the pre-injury states.\u003c/p\u003e\u003cp\u003eCell phones contain lithium-ion batteries that can accidentally overheat or explode. The injuries in this case might be attributed to ignition of the lithium battery in the cell phone following physical damage in the motorcycle accident. While ignition might not have occurred without the accident, lithium-ion batteries comprise a cathode and anode separated by an insulating membrane known as a separator. If this separator is damaged due to significant mechanical impact, thermal runaway can occur, potentially leading to combustion.\u003csup\u003e\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e\u003c/sup\u003e We therefore recommend that cyclists or motorcyclists avoid placing their cell phones in their pockets while riding.\u003c/p\u003e\u003cp\u003eThe genitalia alone comprise about 1% of the TBSA, but this location is of immense functional, anatomical and psychological relevance.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e Previous studies have revealed that genital and perineal burns can significantly impact patient morbidity, with potential long-term sequelae such as scar contracture and urethral stenosis.\u003csup\u003e\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e,\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u003c/sup\u003e While genital burns are commonly associated with major burns, the exact incidence of isolated genital burns is unknown, but may be less than 5% of all genital burns.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u003c/sup\u003e A previous case of left thigh burn due to a cell phone battery overheating involved a second-degree burn that was managed with daily self-dressing.\u003csup\u003e\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e\u003c/sup\u003e In our case, the patient suffered from both genital and left thigh burns due to cell phone combustion following a motorcycle accident. Although the total burn area was at most 2%, most was a full-thickness (third-degree) burn, necessitating surgical intervention. Urethral catheterization is generally not recommended as a standard treatment for genital burns and remains a topic of much discussion, given the risks of urinary tract colonization and harm to the urethra and bowel.\u003csup\u003e\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e,\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e However, we continued urethral catheter management to stent the urethra. After removing the urethral catheter, the patient was able to urinate spontaneously and no longer required fluid management.\u003c/p\u003e\u003cp\u003eGenerous conservative treatment is often employed for most cases of second-degree genital and perineal burns.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e Conservative wound treatment after burn injury is frequently recommended for children, with surgical treatment and STSG reserved for severe burns, as children generally have better healing capacity than adults.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e The treatment of deep dermal and full-thickness genital burns is much more challenging. In the present case, we waited for demarcation of the burn wound with enzymatic debridement based on bromelain, and tangential debridement was performed with a scalpel and curette until bleeding was observed on day 14 post-admission. A previous study recommended full-thickness skin grafts for reconstruction of the penile shaft, since debilitating inelastic and painful hypertrophic scarring was less likely compared with STSG.\u003csup\u003e\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u003c/sup\u003e However, we chose STSG because the penile burn was not circumferential, the post-surgical course was uneventful and the patient was able to resume normal daily activities.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eWe have presented a case of deep dermal and full-thickness genital burns resulting from cell phone combustion. The ignition of the lithium battery in the cell phone was likely attributable to the motorcycle accident. Given that cellular phones are currently a lithium battery-dependent technology, we recommend avoiding placing cell phones in pockets when engaging in strenuous activities to prevent potential burn injuries.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate: not applicable.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsent for publication: The patient provided written, informed consent for publication of the details of this case.\u003c/p\u003e\n\u003cp\u003eConsent to Participate declaration: not applicable\u003c/p\u003e\n\u003cp\u003eFunding: No funding was received for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAdditional Information\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAuthor Contributions\u003c/p\u003e\n\u003cp\u003eAll authors have reviewed the final version to be published and agreed to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003eConcept and design: Koshi Ota\u003c/p\u003e\n\u003cp\u003eAcquisition, analysis, or interpretation of data: Koshi Ota, Saki Mizutani, Kanna Ota\u003c/p\u003e\n\u003cp\u003eDrafting of the manuscript: Koshi Ota, Saki Mizutani, Kanna Ota, Akira Takasu\u003c/p\u003e\n\u003cp\u003eCritical review of the manuscript for important intellectual content: Koshi Ota, Saki Mizutani, Kanna Ota, Akinori Asaka, Yuri Yae, Akira Takasu\u003c/p\u003e\n\u003cp\u003eSupervision: Akira Takasu, Takashi Nuri\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003cstrong\u003eDisclosures\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed Consent: The patient provided written, informed consent for publication of the details of this case.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Conflicts of Interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following:\u003c/p\u003e\n\u003cp\u003ePayment/services info: All authors have declared that no financial support was received from any organization for the submitted work.\u003c/p\u003e\n\u003cp\u003eFinancial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work.\u003c/p\u003e\n\u003cp\u003eOther relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eYoshino Y, Ohtsuka M, Kawaguchi M, et al. The wound/burn guidelines \u0026ndash; 6: Guidelines for the management of burns. \u003cem\u003eJournal of Dermatology\u003c/em\u003e. 2016;43(9):989-1010. doi:10.1111/1346-8138.13288\u003c/li\u003e\n\u003cli\u003eMankowski PJ, Kanevsky J, Bakirtzian P, Cugno S. Cellular phone collateral damage: A review of burns associated with lithium battery powered mobile devices. \u003cem\u003eBurns\u003c/em\u003e. 2016;42(4):e61-e64. doi:10.1016/j.burns.2015.10.012\u003c/li\u003e\n\u003cli\u003ePovolotskiy R, Gupta N, Leverant AB, Kandinov A, Paskhover B. Head and Neck Injuries Associated with Cell Phone Use. \u003cem\u003eJAMA Otolaryngol Head Neck Surg\u003c/em\u003e. 2020;146(2):122-127. doi:10.1001/jamaoto.2019.3678\u003c/li\u003e\n\u003cli\u003eHarpole BG, Wibbenmeyer LA, Erickson BA. Genital burns in the national burn repository: Incidence, etiology, and impact on morbidity and mortality. \u003cem\u003eUrology\u003c/em\u003e. 2014;83(2):298-303. doi:10.1016/j.urology.2013.10.039\u003c/li\u003e\n\u003cli\u003eSmith DC, Schreiber KM, Saltos A, Lichenstein SB, Lichenstein R. Ambulatory cell phone injuries in the United States: An emerging national concern. \u003cem\u003eJ Safety Res\u003c/em\u003e. 2013;47:19-23. doi:10.1016/j.jsr.2013.08.003\u003c/li\u003e\n\u003cli\u003eLiu Z, Jiang Y, Hu Q, et al. Safer Lithium-Ion Batteries from the Separator Aspect: Development and Future Perspectives. \u003cem\u003eEnergy and Environmental Materials\u003c/em\u003e. 2021;4(3):336-362. doi:10.1002/eem2.12129\u003c/li\u003e\n\u003cli\u003eBaba PUF, Shah RA, Rasool A, Kaul A, Wani AH. Perineal burns: Epidemiology, severity factors, management issues and outcome. \u003cem\u003eBurns Open\u003c/em\u003e. 2022;6(2):97-104. doi:10.1016/j.burnso.2022.03.003\u003c/li\u003e\n\u003cli\u003eBonaventura B, Panayi AC, Hummedah K, et al. Outcomes in patients with burns to the perineum, buttocks and genitalia: A retrospective cohort study. \u003cem\u003eBurns\u003c/em\u003e. 2024;50(3):767-773. doi:10.1016/j.burns.2023.10.003\u003c/li\u003e\n\u003cli\u003eDovirak I, Arbel EJ, Reese AD, et al. Genital burn injuries: Insights from 10 years of consumer product-related incidents. \u003cem\u003eBurns\u003c/em\u003e. 2025;51(5). doi:10.1016/j.burns.2025.107457\u003c/li\u003e\n\u003cli\u003eSchulz A, Ribitsch B, Fuchs PC, Lipensky A, Schiefer JL. Treatment of Genital Burn Injuries: Traditional Procedures and New Techniques. \u003cem\u003eAdv Skin Wound Care\u003c/em\u003e. 2018;31(7):314-321. doi:10.1097/01.ASW.0000532474.34841.d0\u003c/li\u003e\n\u003c/ol\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijem","sideBox":"Learn more about [International Journal of Emergency Medicine](https://intjem.biomedcentral.com/)","snPcode":"12245","submissionUrl":"https://submission.nature.com/new-submission/12245/3","title":"International Journal of Emergency Medicine","twitterHandle":"@IntJEmergMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"cell phone, genital burns, deep dermal burn, full-thickness (third-degree) burn","lastPublishedDoi":"10.21203/rs.3.rs-7239351/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7239351/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eThermal injuries are common in emergency departments, but rarely involve isolated genital burns. However, burns caused by electronic devices, particularly cell phones, represent an emerging concern.\u003c/p\u003e\u003ch2\u003eCase Presentation:\u003c/h2\u003e\u003cp\u003eA 47-year-old man presented with third-degree burns to the left anterior thigh, penis, and scrotum, covering 2% of the total body surface area, accompanied by facial fractures. These injuries had been sustained in a collision. A burned cell phone was discovered in clothing adjacent to the perineum, leading to the suspicion that it had ignited in his trouser pocket, causing burns in addition to trauma from the collision. He underwent surgical debridement and split-thickness skin grafting on hospital day 14. Despite the severity of the injury, the patient achieved complete epithelialization and recovered pre-injury urological and sexual function by the 3-month follow-up. To our knowledge, this represents the first report of deep dermal and full-thickness genital burns caused by cell phone combustion.\u003c/p\u003e\u003ch2\u003eConclusions\u003c/h2\u003e\u003cp\u003eThis case highlights the potential for severe thermal injuries from cell phones, possibly exacerbated by trauma, and underscores the importance of patient education regarding the safe handling and storage of cell phones, particularly during activities like cycling or motorcycling.\u003c/p\u003e","manuscriptTitle":"Genital burns caused by cell phone combustion following a motorcycle accident: a case report","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-01 08:58:22","doi":"10.21203/rs.3.rs-7239351/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-08-27T00:17:05+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"287755856748816399487974619613206231941","date":"2025-08-26T19:27:34+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"185746038311064901370892561714023234672","date":"2025-08-24T14:48:36+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-23T05:39:08+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-22T09:39:53+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-08-21T16:31:51+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"21793233998489212769985134064137440513","date":"2025-08-21T16:22:15+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"136760007295909326307840439169562351923","date":"2025-08-21T15:06:49+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"304315311108102592291105119724749803656","date":"2025-08-21T04:43:21+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"142268556536400184365824053809722848463","date":"2025-08-20T04:24:42+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"121621083104900403958660188151406515085","date":"2025-08-19T15:37:58+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"170704507428770716786812376628098403674","date":"2025-08-19T14:54:54+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-19T14:36:39+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-08-08T15:10:19+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-08-08T15:08:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"International Journal of Emergency Medicine","date":"2025-07-29T05:38:47+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"international-journal-of-emergency-medicine","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ijem","sideBox":"Learn more about [International Journal of Emergency Medicine](https://intjem.biomedcentral.com/)","snPcode":"12245","submissionUrl":"https://submission.nature.com/new-submission/12245/3","title":"International Journal of Emergency Medicine","twitterHandle":"@IntJEmergMed","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"BMC/SO AJ","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"2480d0c5-81f3-4d9b-81dd-8f61903f5605","owner":[],"postedDate":"September 1st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-10-13T16:05:53+00:00","versionOfRecord":{"articleIdentity":"rs-7239351","link":"https://doi.org/10.1186/s12245-025-01002-2","journal":{"identity":"international-journal-of-emergency-medicine","isVorOnly":false,"title":"International Journal of Emergency Medicine"},"publishedOn":"2025-10-06 15:58:27","publishedOnDateReadable":"October 6th, 2025"},"versionCreatedAt":"2025-09-01 08:58:22","video":"","vorDoi":"10.1186/s12245-025-01002-2","vorDoiUrl":"https://doi.org/10.1186/s12245-025-01002-2","workflowStages":[]},"version":"v1","identity":"rs-7239351","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7239351","identity":"rs-7239351","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}