Management of electrical injuries of the abdomen

High voltage electrical burns may involve intra-abdominal viscera with or without an abdominal wound. The risk of such an involvement is much higher when a wound is present. Depending upon the amount of heat produced vapourization of tissues may occur. If it includes part of the peritoneum, visceral damage is revealed immediately. If it does not occur to that extent, necrosed tissues remain in continuity and visceral involvement remains concealed until slough separates. The prognosis is related to early diagnosis of the associated visceral injury. It is recommended that the debridement should be undertaken at 2-3 days postburn. Laparotomy is indicated if part of the peritoneum is also debrided. Reconstruction of the abdominal wall may be a formidable task. Among the options available, pedicled muscle and musculocutaneous flaps seem to be ideally suited for the purpose.