TREATMENT OF A PATIENT WITH SEVERE HIGH-VOLTAGE ELECTRICAL INJURY: A CLINICAL CASE
Z Bilalov1, M Rashova2, B Tuleubayev1
11Department of Surgical Diseases, "Karaganda Medical University", Kazakhstan.
Abstract:
A 32-year-old patient sustained a high-voltage electrical injury while touching live parts of railway equipment. Examination revealed electrical burns of mixed depth covering a total area of 42%, 25% of which were deep grade IIIB burns. The affected area included the face, neck, torso, and right extremities. The Frank burn index was 92 units, consistent with an extremely severe burn injury. Laboratory tests revealed a pronounced systemic inflammatory response, hypoproteinemia, signs of metabolic stress, and activated coagulation. Bilateral lower lobe pneumonia and retinal angiopathy were also diagnosed. The patient received intensive fluid, antibacterial, and analgesic therapy. Local wound care and vital signs were monitored daily. Six staged surgeries were performed-a series of necrectomy procedures on October 15, 20, 22, 24, 28, and 31, 2025-aimed at removing necrotic tissue, reducing the toxic load, and preventing the development of infectious complications. Against the background of complex treatment, positive clinical dynamics, stabilization of laboratory parameters and improvement of the condition of burn wounds were noted, which made it possible to proceed to the stage of closing the defect from the received burn injuries, which took place on 13.11.2025. This case demonstrates that successful treatment of high-voltage electrical burns is only possible with early intensive care, sequential surgical interventions, and ongoing monitoring for metabolic and infectious complications.
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