A case-matched controlled study on high-voltage electrical injuries vs thermal burns

Area of Science:

• Trauma Surgery
• Burn Management
• Microsurgery

Background:

• High-tension electrical injuries present unique surgical challenges compared to thermal burns.
• Evidence comparing surgical management outcomes for electrical versus thermal burns is limited.
• Understanding complications and optimal surgical strategies is crucial for patient recovery.

Purpose of the Study:

• To compare the surgical management and outcomes of high-tension electrical burn injuries with thermal burns.
• To provide a higher level of evidence through a case-controlled study design.
• To identify specific complications and risk factors associated with electrical burn injuries.

Main Methods:

• A case-controlled study design was employed, matching 68 high-tension electrical burn patients with thermal burn patients.
• Data collected included accident cause, concomitant injuries, burn characteristics, surgical procedures, complications, and hospital stay.
• Statistical analysis compared outcomes between the two groups, including operation frequency, amputation rates, and hospitalization duration.

Main Results:

• Electrical burn patients underwent significantly more operations (5.2 vs 3.3) and had higher amputation rates (19.7% vs 1.5%).
• Escharotomy/fasciotomy rates (47% vs 21%) and hospitalization days (44 vs 32) were also significantly higher in the electrical burn group.
• Elevated creatinine kinase levels correlated with amputations; free flap failure occurred within 4 weeks post-trauma, suggesting a progressive vascular lesion.

Conclusions:

• High-tension electrical injuries necessitate complex surgical management with higher complication rates than thermal burns.
• A vulnerable period of up to 4 weeks exists for free flap coverage due to potential progressive intima lesions.
• Pedicled flaps may serve as a safer alternative to free flaps during this critical post-trauma phase.