Burned Bridges: Cutaneous Burn Overlying Hernia with Loss of Domain- A Case Report

Abstract Background Ventral hernias with loss of domain present significant operative challenges. Thermal injury to the overlying skin is rare and complicates management, especially when standard burn care typically requires surgical excision. Case Presentation We report a 70-year-old female with multiple comorbidities, and a large recurrent ventral hernia with loss of domain who suffered a 1% total body surface area (TBSA) full-thickness burn overlying the hernia following contact with an oven door. Due to risks of operative complications such as inadvertent enterotomy, the patient was managed nonoperatively. The eschar was cross-hatched using a scalpel at bedside. The burn was treated topically with twice-daily Silvadene cream. She was discharged home on her third hospital day and was monitored with routine outpatient follow-up. Conclusions This report highlights a rare clinical scenario when the skin over a ventral hernia defect develops a burn injury. We demonstrate that full-thickness burns in carefully selected patients may be treated nonoperatively, preventing misadventure with a large hernia with loss of domain. This approach may reduce operative complications in high-risk patients but should be applied cautiously.