A Modified Approach in the Treatment of Electrical burn

The electrical burns constitute a unique type of thermal injury and usually consist of a limited area of cutaneous burn, but associated with deep muscle damage of variable extent. The deep tissue destruction resulting from such injury leads to high incidence of amputation. So electrical burns are different from other types of injuries requiring individualized and varied methods of treatment, such as early fasciotomy, repeated debridement, wound coverage and technique of amputation. During 5 years from Jan. 1988 to Dec. 1992, we experienced 310 cases of electrical burn. We analyzed these cases on the aspects of functional result and necessity of amputation according to the treatment variability. The result showed the extent of burn in amputation group was 11.6%, salvage group 13.1%, with no difference of extent between 2 groups(p>0.05, by qui square test). When the fasciotomy was done earlier than 12 hours after injury showed 39.1% of more than good functional result, when later than 12 hours 7.7% of more than good, that is, earlier fasciotomy resulted in better function(p<0.05, qui square test). The amputation rate was 23.9% during the last 5 years which was a marked improvment when compared to the previous ten years(32.4%). From these results we concluded that in order to reduce the rate of amputation and to improve the function of patients, early fasciotomy, early repeated debridement and wound coverage is necessary.