Plastic surgical considerations in lighting injuries

Lightning injuries affect 1,000 to 1,500 people per year in the United States. While fatalities are uncommon, lightning frequently causes injuries within the treatment purview of the plastic surgeon. Recognition of common patterns of lightning injury, their prognosis, and treatments are important for the plastic surgeon. Lightning injury, although electrical, is very different from other more common electrical injuries. Burn injuries are seen, but are usually superficial and heal without surgery. Deep-tissue injury is rare. Neurovascular compromise of the extremities is common and may lead to plastic surgical consultation for intervention. Spontaneous recovery is the rule, however. Several patients are described who illustrate these injuries, and treatment guidelines are proposed.