An Eleven-Year Survey of Electrical Burn Injuries

Transcription

1 An Eleven-Year Survey of Electrical Burn Injuries Melunet A. Haberal, MD, FACS AU/lara} Turkey One hundred eighty-six patients with electrical burns were treated within an Lf.-year period at The Hacettepe University Burn Unit. Both children and adults were treated in this burn unit. The main causes of injury were misuse of electrical appliances, inattentiveness, lack of education in safety precautions, and lack ofparental supervision. Treatment consisted of first, normal resuscitation in which Ringer's lactate solution was administered (according to the Parkland formula). Fluid resuscitation was followed by debridement, fasciotomy, and escharatomy. Two major complications were encountered: musculoskeletal involvement in 44% ofpatients, which required major amputation in 79%, and acute renal failure in 14.51% of patients. In spite of treatment with peritoneal dialysis or hemodialysis, the mortality rate for patients with renal failure was quite high (59%). To decrease the number of complications, closer monitoring of patients and early surgical decompression were applied. The results of this survey demonstrate the need for burn prevention programs in Turkey. Physicians and health care officials have an obligation to educate the public about the prevention ofelectrical burns. The results ofthis study and other studies on electrical burns should be communicated to the public through every available means. (J BURN CARE REHABIL 1995;16:43-8) Electricity is a source of energy that has become a part ofthe way ofliving in the West where the public has been well educated regarding its benefits and the injuries that may occur when it is used improperly. As a result ofthis education, the western world tends to have fewer casualities ofelectrical injury than third world countries. These countries have yet to realize the critical importance of taking the necessary lifesaving precautions in the use ofelectricity. Untilsuch action has been fully carried out, the great wonders of electricity will only lead to a continuous increase in the number ofelectrical injuries.1-3 This study documents electrical injuries and their complications over a period of11 years in The Hacettepe University Burn Unit. METHODS Patients. From January 1, 1979, to December 31, 1990, 968 patients with burns from various parts of Turkey were admitted to our burn center (Figure 1). From thetransplantation andburu Unitsnt thehaccttepc University Hospitals mid Turkish Transplantation andbu/1/ Foundntion Hospitnl. Reprint requests: Mehmet A. Haberal, MD, FACS, 1. Cd., No:77, Knt:4, BnlJfelieJ'ler Ankara Turkey. CopyriglJt 1995 bybu/1/ Science Publishers, Inc, /95/$ / One hundred eighty-six (19.21 %) of these patients had electrical burn injuries, which included 42 (22.58%) flash burns, 91 (48.92%) high-voltage burns, and 53 (28.49%) burns that were caused by household circuits. Not included in this group are four patients who died as a result of electrical injury that was caused by lightning. Fifty-three (28.49%) of the patients were younger than 15 years of age; mean age was years. Forty-three patients (81.13%) were boys and 10 (18.87%) were girls (Figure 2). In the group ofpatients who were older than 15 years of age (mean age, years), 117 (87.97%) were boys or men and 16 (12.03%) were girls or women. Ofthe patients who were older than 15 years of age, nine were unemployed, four were retired, and 15 were students. The occupations of.the employed patients are shown in Figure 3. The majority ofpatients came from the Central Anatolian Region, but the rest came from various parts ofturkey (Figure 4). Causes of Injury. The causes of electrical burn injury in the majority of patients who were under the age of 15 were contact with live wire as a result of climbing electrical poles or direct contact with electrical outlets. In one case, a child cut the cord of an iron with a pair of scissors. Wound sites in this group included the head and face, the back, and left and right upper and lower 43 Downloaded from

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