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At least 19 recordsLinked to original sources
PubMed1993

Chronically exposed calvarium following electrical burns.

Electrical burns of the scalp and calvarium are uncommon, but due to various conditions peculiar to India such injuries are seen frequently. The presentation of such patients at hospital is late because of the paucity of specialized care facilities and understanding of the disease process. Such injuries usually cause necrosis of the scalp and underlying calvarium with sequestered bone being retained in situ by the flimsy adhesions of underlying granulation tissue and overhanging edges of the scalp all around caused by secondary wound contraction. This paper gives our experience of 14 such cases, explaining the reasons for the chronic state and their subsequent clinical management.

Adult↗
PubMed2000

Electrical burns.

Electrical burns can be divided into flash or typical thermal injury and high-tension injury. The latter is usually caused by greater than 1000 volts and produces a clinically characteristic entry and exit wound. The optimal management of patients with high-tension electrical injury has evolved into a plan of urgent exploration and debridement, aggressive redebridement, and early wound closure.

Burns, Electric↗
PubMed2005

Modern concepts of treatment and prevention of electrical burns.

Electric injuries account for 1,000 deaths in the United States, with a mortality rate of 3--15%. As the widespread use of electricity and injuries from it increase, all health professionals involved in burn care must appreciate its physiological and pathological effects as well as management of electrical current injury. Electric current exists in two forms: alternating current and direct current. The effects of electricity on the body are determined by seven factors: (1) type of current, (2) amount of current, (3) pathway of current, (4) duration of current, (5) area of contact, (6) resistance of the body, and (7) voltage. Electrical accidents can be divided into less than 1,000 V (low-voltage accidents) and greater than 1,000 V (high-voltage accidents). In any electrical accident, the witness must turn off the power source and initiate treatment at the scene of the injury. Low-voltage electric burns almost exclusively involve either the hands or oral cavity. Surgical treatment will vary with the severity of the injury. Burns caused by contact with a high-voltage alternating electric circuit conforms to two types: burns from an electric arc and burns from an electric current. High-voltage electric current injuries have a wide variety of systemic manifestations, including neurologic complications, cardiovascular and pulmonary manifestations, vascular damage, and abdominal, bone, eye and joint complications. An organized approach to the management of these complications is outlined in this article. The best treatment of burn injuries remains prevention. Because the majority of burn injuries are due to occupational electrical injuries, the regional burn centers must work effectively with industry to prevent these potentially life-threatening accidents.

Anti-Bacterial Agents↗
PubMed1995

Acute electrical burns.

Electric current can damage an individual by thermal heating of the tissues; by disregulating autonomously functioning organ systems, such as the circulatory and respiratory systems; or by once-only or continuing stimulation of the nerves and striated muscles. In the first case, the result is coagulation necrosis, and in the second case life-threatening events can occur, such as arrhythmia or apnea. In the third case, vigorous nerve stimulation can lead to paralysis and vasospasm. Massive muscle contractions due to nerve stimulation or the direct triggering of striated muscles can cause ruptures, ligamentous tears, fractures, and joint dislocations, while prolonged current passing through the thoracic wall may stimulate tetany of the intercostal muscles and diaphragm resulting in asphyxia. This article is confined to a description of thermal or Joule heating of tissues when they form part of an electric circuit and to the effects of direct nerve and muscle stimulation. Other articles discuss nonthermal effects. The injuries a person sustains as the result of an electrical accident depend on a large number of interrelated factors, such as the properties of the electrical power supply, the magnitude and duration of current flow, the current pathway, and skin conditions. It makes a vast difference whether a person is hit by a lightning bolt (extremely high voltage, short current flow) or receives a shock from an electrical power supply (low to high voltage, relatively long current flow). Wide variation in the physical properties of lightning discharges and the discharges from electrical power supplies at home and in industry means that all kinds of injuries can be encountered.

Acute Disease↗
PubMed1986

Electrical burns.

Electrical injury is unlike other burns because of extensive local destruction of tissue at the points of entrance and exit. Artz likened it to a severe muscle crush injury, whereas Hunt showed that the deep-tissue loss is secondary to extremely high temperatures from resistance of the tissues (skin and bone) to the passage of electric current. Although Joule's equivalent explains the heat exchange (often in thousands of degrees of centigrade) with many variables to be considered, it is usually the voltage that can be determined and probably is the most important factor. High tension (more than 1000 volts) and low tension (less than 1000 volts) and direct and indirect currents all exert differing effects. Arc burns can occur without the patient contacting the electrical source but can be quite destructive. Electrical injury can affect many organ systems, depending on the path of the current. The volume conductor theory explains why extremity burns are much worse than torso burns and why extensive débridement (particularly of periosseus muscle) is usually necessary. The progressive destruction of tissue is probably best explained by small vessel occlusion and possibly also by elevated levels of arachidonic acid in areas of greatest heat production. Antithromboxane agents have halted the progression in experimental animals; muscle biopsies and an increased uptake of technetium Tc 99m pyrophosphate help to determine nonviable tissue that must be débrided. Resuscitation must be aggressive to provide adequate circulatory volume. Normal vital signs should be maintained along with a urine output of 100 ml per hour to overcome the destructive renal tubular effect of myoglobin and hemoglobin products. Control of sepsis and its complications through aggressive wound management is critical for survival. Long-term problems from electrical injury are possible, and efforts at prevention may save life and limb.

Blood Vessels↗
PubMed2005

Principles of microvascular reconstruction in burn and electrical burn injuries.

Free tissue transplantation is a rarely indicated procedure in burn reconstruction. As the versatility and variability of free flaps have significantly developed during recent years, so have the indications for this procedure expanded. This study reports retrospectively the results of 75 free flaps in 60 severely burned patients using 20 different free flaps. This experience enabled us to establish reconstructive principles pertinent to the type of injury (burn versus high voltage injuries) and the timing of reconstruction procedures. In high voltage injuries (n = 26) early free flap coverage (<21 days after trauma) with muscular flaps was the most frequently used type of reconstruction. Reconstruction site was predominantly the upper extremity and forearm. In burn injuries (flame, contact, fluid), free flap coverage was performed during a later stage of the treatment course (3-6 weeks after trauma), or as a secondary procedure. Reconstruction with cutaneous flaps was the preferred method. In contrast to high voltage injuries, the trunk and the face were also recipient sites. In the upper extremity, the elbow and dorsum of the hand were the most frequent sites of reconstruction. Overall, the flap failure rate was 13% (n = 10). We were able to show a relationship between flap failure rate and timing of the procedure. Eight out of 10 flap failures occurred within 5-21 days after trauma, all 10-flap failures occurred between 5 days and 6 weeks. No flap failure occurred during secondary reconstruction. For the reconstruction of complex or large defects (n = 14), we recommended combined 'chimeric' flaps, pre-expansion of free flaps, or the combination of a free and local flap. Our data demonstrate that burn and high voltage injuries are distinct entities, each requiring custom tailored reconstructive solution.

Abdominal Injuries↗
PubMed2007

Microvascular reconstruction in burn and electrical burn injuries of the severely traumatized upper extremity.

BACKGROUND: As the versatility and variability of free flaps have significantly increased during recent years, so have the indications for free tissue transplantation in burn reconstruction expanded. METHODS: The authors report retrospectively the results of 42 free flaps for upper extremity reconstruction in 35 severely burned patients using 13 different free flaps. This experience enabled the authors to establish reconstructive principles pertinent to the type of injury (burn versus high-voltage injuries) and the timing of reconstruction procedures. RESULTS: In high-voltage injuries (n = 17), early free flap coverage with muscular flaps was the most frequently used type of reconstruction. The reconstruction site was predominately the forearm. In burn injuries, free flap coverage was performed during a later stage of the treatment course. Reconstruction with cutaneous or fascial flaps was the preferred method. The elbow and dorsum of the hand underwent defect coverage in most circumstances. For reconstruction of complex or large defects (n = 6), combined "chimeric" flaps were used. Overall, the flap failure rate was 12 percent (n = 5). Interestingly, there was a relationship between flap failure rate and timing of the procedure. Four of five flap failures occurred within 5 to 21 days after trauma, and all five flap failures occurred between 5 days and 6 weeks. No flap failure occurred during secondary reconstruction. CONCLUSIONS: The authors' data demonstrate that burn and high-voltage injuries are distinct entities, each requiring custom-tailored reconstructive solutions for limb salvage. Even if the authors' flap failures all occurred during the first 6 weeks, it should not be forgotten that this type of coverage is the only alternative to amputation in selected cases.

Adolescent↗
PubMedDate not supplied

Burns in southern Turkey: electrical burns remain a major problem.

In Turkey, burns represent a relatively small number of injuries overall, but they continue to be a major public health problem. Our aim in this study was to identify risk factors that affect outcome in burn patients hospitalized in the southern part of our country, with special emphasis on electrical burns. The database for 109 burn patients who were admitted to our burn center from April, 2000, through August, 2001, was retrospectively analyzed. Electrical injury was the cause of burn in 23 (21%) of the 109 cases. The burn causes differed among age groups and between the sexes, with males constituting 95% of the electrical burn patients. The mortality rate for the electrical burn group was lower than the rate for the rest of the burn patients (1/23 vs 17/86, respectively; P <.001); however, the opposite was true for complication rate (10/23 vs 5/86, respectively; P <.001), cost of treatment (8351 US dollars vs 5122 US dollars, respectively; P =.009), and length of hospital stay (39.9 vs 26.2 days, respectively; P < 0.001). The rate of electrical burn injury in Turkey has changed very little in the past two decades. This underlines the need for stronger efforts aimed at prevention, such as better public education and strict regulations regarding the distribution and use of electricity.

Adolescent↗
PubMed1976

Bracelet burn-an unusual electric burn.

A car mechanic sustained a deep partial thickness burn of the wrist when his metal watch strap short circuited the battery of a car upon which he was working.

Adult↗
PubMed2005

[Indoor electric burns in children].

BACKGROUND: Electric burns are serious public health problems that comprise 3.5% of the burns that refer to the hospital. By biting and sucking the electric cords, mouth and lip burns occur in the children. The mortality rate is 90% in the children who had cardiac arrest before coming to the hospital. In this study, the electric burns that were followed-up in our clinic were reported. MATERIAL AND METHODS: Four cases with electric burns followed-up in our clinic between September 2002 February 2003; were assessed. The cases were called back to control one and six months after the burn incident and the indoor precautions required were appraised. RESULTS: The mean ages of two male and two female children were respectively 23.6+/-10.6 months (10 - 36 months). Two of the four cases with burns had played with electric plugs and the other two had bitten the cords. The indoor precautions had still not been taken at the first and six months of the follow up period. CONCLUSIONS: House visits are important since the preventive measures are not usually taken at home. In consideration of higher incidence of exposure to indoor accidents during childhood, the best way to avoid accidents is to take preventive measures against them.

Accidents, Home↗
PubMed1998

[The treatment and rehabilitation of high-voltage electric burns].

High-voltage electric burns is refractory with high rate of amputation (46%) in early stage and unfavorable functional recovery in later stage. Little breakthrough has so far been made in this respect. From Jan. 1985 to Jan. 1996, ninety-six cases with high-voltage burns were treated in our department. Seventy-one cases of various tissue flap grafting were applied to treat early electric burns, among which sixty-four cases were successful. The amputation rate was reduced to 30%. Postoperatively, a long-term rehabilitation training at home was carried out. Most of them achieved a good appearance of the wounded sites and limbs and satisfactory ability to work or self-care. It was suggested that early thorough debridement of necrosis tissue, careful reservation of living tissue, appropriate choice of tissue flap and postoperative rehabilitation training were of great importance to achieve a good prognosis.

Adolescent↗
PubMed2000

[Early surgical treatment of low-voltage electric burns of the hand in children].

Electrical burns give not more than 8% in the structure of burns in children. Most of the children suffer from burns by electrical current of 220 V, and invalidisation of the children can result from inadequate surgical treatment. Advantages of early operative treatment (primary or delayed necrectomy with different kinds of primary skin plastic) are proved as compared with traditional plastic of the granulating wounds. This method can be considered to be the method of choice in treatment of children with low voltage electrical burns of the hand.

Adolescent↗
PubMedDate not supplied

Posttraumatic stress disorder in electric burn patients.

It was hypothesized that burn injuries electric in origin may have a poor prognosis for rehabilitation and return to work. Ten electrically injured burn patients were compared to seven patients whose burns were nonelectric, after all 17 had shown clinically significant emotional problems during rehabilitation. Results of psychological tests from both groups were also compared to results in three other groups: psychiatric, chronic pain, and blepharospasm patients. Results indicated that patients with electric burns had the most severe psychopathologic symptoms and the least likelihood of returning to work. Only the factor of educational background was predictive of degree of psychological distress, prognosis for returning to work, and response to psychological intervention. Results are discussed within a one-trial aversive conditioning paradigm potentially unique to electric injuries.

Adult↗
PubMed1994

Electrical burns associated with head injuries.

Although electrical burns account for a small portion of all thermal injuries, their treatment becomes more complex when associated with injuries of other organs. From July 1987 through December 1991, 8 of 249 burned patients sustained electrical burns associated with head injuries. The mean total body surface area burned was 19% (range, 2%-45%). Computed tomographic (CT) scans of the brain revealed that six patients with moderate to severe head injuries had intracranial hemorrhage including three cases of intracerebral hematoma and another three cases of epidural hematoma. Half of these patients underwent surgical intervention for removal of intracranial hematomas and a compound depressed fracture segments of the skull, and the others were treated conservatively. All the patients progressively recovered consciousness with Glasgow Coma Scale scores of 14 or more and minimal neurologic sequelae. The combination of early detection and prompt removal of life-threatening intracranial hematomas with aggressive support of electrical victims who appear dead would minimize the morbidity and mortality in patients with electrical burns and head injuries.

Adolescent↗