Acute electrical burns: a 10-year clinical experience.

We have reviewed 113 cases of electrical burns treated at the Cook County Hospital Burn Center during the past 10 years. There were 3265 acute burn admissions during this period. the incidence of electrical burns being 3.5 per cent. Low-voltage electrical burns occurred in 82 of the 113 patients (73 per cent). These were caused mostly by household electricity supplies, occurred in children, and were preventable. Arc burns of the perioral region were allowed to heal spontaneously. The surgical management of other arc burns and flash burns was similar to that for most deep burn wounds. The incidence of high-voltage electrical injuries was 27 per cent in our series. Over 50 per cent of these injuries were not work-related. These tended to occur outside the home in young adult males and were also frequently preventable. None of these patients developed acute renal failure. Early surgical debridement of devitalized tissue with allografting, followed by delayed definitive wound closure or amputation prevented septic complications. Early fasciotomy appeared to have little effect on complete limb salvage. Limb loss continues to be the major factor contributing to the high morbidity associated with these injuries. All 113 patients survived. We attribute this to early transfer of patients to our Burn Unit, aggressive fluid resuscitation, continuous haemodynamic and metabolic support, and early surgical intervention.