Acute electrical burns: a 10-year clinical experience |
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| Authors: | M L Hanumadass S B Voora R J Kagan T Matsuda |
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| Institution: | 1. Department of Hand Surgery, Huashan Hospital, Fudan University, 12 Wulumuqi Zhong Road, Shanghai 200040, China;2. Key Laboratory of Hand Reconstruction, Ministry of Health, Shanghai, China;3. Shanghai Key Laboratory of Peripheral Nerve and Microsurgery, Shanghai, China;1. Department of Burns, Heilongjiang Provincial Hospital, Harbin, China;2. Department of Emergency Medicine, The First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China;3. Department of Burns, The Fifth Hospital of Harbin, Harbin, China;4. Department of Critical Care Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China;5. Laboratory for Shock and Multiple Organ Dysfunction of Burns Institute, Key Research Laboratory of Tissue Repair and Regeneration of PLA, and Beijing Key Research Laboratory of Skin Injury and Repair Regeneration, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing, China;6. Shanghai Sandai Pharmaceutical R&D Co, Ltd, Pudong, Shanghai, China;1. Department of Burns, the Fifth Hospital of Harbin, Harbin, 150040, China;2. Laboratory for Shock and Multiple Organ Dysfunction of Burns Institute, Key Research Laboratory of Tissue Repair and Regeneration of PLA, and Beijing Key Research Laboratory of Skin Injury and Repair Regeneration, First Hospital Affiliated to the Chinese PLA General Hospital, Beijing 100048, China;3. School of Medical Science, Faculty of Science Office, Level 2, Carslaw Building (F07), University of Sydney, NSW 2006, Australia;4. Department of Emergency Medicine, First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, China;5. Department of Human Resources, the First Hospital of Harbin, Harbin 150010, China;6. Department of Burn Surgery, the General Hospital of Armed Police Forces, Beijing 100039, China;7. Shanghai Sandai Pharmaceutical R&D Co., Pudong, Shanghai 201203, China;2. St George’s University Hospital NHS Foundation Trust, Department of Plastic and Reconstructive Surgery, London, United Kingdom;1. Department of Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan;2. Mechanical Engineering, Michigan Medicine, University of Michigan, Ann Arbor, Michigan;1. Shriners Hospitals for Children, Galveston, TX;2. Department of Surgery, University of Texas Medical Branch, Galveston, TX;3. Sealy Center for Molecular Medicine and the Institute for Translational Science, University of Texas Medical Branch, Galveston, TX;4. Department of Surgery, Division of Plastic Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada |
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| Abstract: | We have reviewed 113 cases of electrical burns treated at the Cook County Hospital Burn Center during the past 10 years. There were 3265 acute burn admissions during this period. the incidence of electrical burns being 3.5 per cent. Low-voltage electrical burns occurred in 82 of the 113 patients (73 per cent). These were caused mostly by household electricity supplies, occurred in children, and were preventable. Arc burns of the perioral region were allowed to heal spontaneously. The surgical management of other arc burns and flash burns was similar to that for most deep burn wounds. The incidence of high-voltage electrical injuries was 27 per cent in our series. Over 50 per cent of these injuries were not work-related. These tended to occur outside the home in young adult males and were also frequently preventable. None of these patients developed acute renal failure. Early surgical debridement of devitalized tissue with allografting, followed by delayed definitive wound closure or amputation prevented septic complications. Early fasciotomy appeared to have little effect on complete limb salvage. Limb loss continues to be the major factor contributing to the high morbidity associated with these injuries. All 113 patients survived. We attribute this to early transfer of patients to our Burn Unit, aggressive fluid resuscitation, continuous haemodynamic and metabolic support, and early surgical intervention. |
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