Aggressive approach to the extremity damaged by electric current.

Area of Science:

• Trauma Surgery
• Burn Management
• Orthopedic Surgery

Background:

• Electrical current injuries frequently affect extremities, posing a risk of limb loss.
• Timely intervention is critical for managing tissue damage and preserving function.

Purpose of the Study:

• To evaluate the effectiveness of early surgical exploration and fasciotomy in salvaging limbs affected by electrical current injuries.
• To assess the outcomes of surgical management and reconstructive techniques in these complex cases.

Main Methods:

• Retrospective review of 75 patients with electrical burns over 11 years.
• Analysis of 41 patients with extremity electrical current injuries.
• Surgical exploration, decompression, debridement, and fasciotomy based on physical findings.
• Use of biologic dressings, local, and free flaps for wound closure.

Main Results:

• 27 limbs in 14 patients underwent prompt exploration and debridement.
• 10 extremities were salvaged, while 11 required major amputation during initial surgery.
• No extremity requiring exploration was missed.
• No renal failure or deaths from retained necrotic tissue were observed.

Conclusions:

• Early surgical intervention, including exploration and fasciotomy, is crucial for limb salvage in electrical current injuries.
• Aggressive debridement and appropriate wound closure methods, including flaps, are essential for successful outcomes.
• This approach minimizes complications such as renal failure and mortality.