Electrical Burns: A Retrospective Study at the Lebanese Burn Center in Geitaoui Hospital, Lebanon (2011–2024)

ABSTRACT

Electrical burns are among the most severe burn injuries, often leading to deep tissue damage, systemic complications, and prolonged hospitalisation. In Lebanon, limited national data on electrical burn injuries limits the understanding of their epidemiology and management. This study aims to assess the prevalence and characteristics of electrical burns in patients admitted to the specialised burn care unit in Geitaoui Hospital in Lebanon. A retrospective observational study was conducted by reviewing the medical records of patients admitted from 1st January 2011 to 31st December 2024. Data on demographics, burn characteristics, hospitalisation outcomes, infections, surgical interventions, and laboratory findings were extracted and analysed using SPSS version 26. Thirty patients were included, with a male predominance (96.7%) and the mean age was 29.6 years. Third‐degree burns were observed in 70.0% of cases, and 66.7% of patients had burns affecting 10%–30% of their total body surface area. High‐voltage injuries accounted for 50.0% of cases. Upper extremities were the most commonly affected site (93.3%). The mean hospital stay was 25.69 days, and the mortality rate was 10.0%. Infection was documented in 43.3% of cases. The most frequently isolated pathogens were Acinetobacter (20.0%) and Pseudomonas aeruginosa (16.7%). Surgical intervention was required in 63.3% of patients, most frequently skin grafting (36.7%). This study contributes national data on electrical burns and emphasises the importance of preventive and multidisciplinary care strategies.

Summary.

• Electrical burns are associated with severe tissue damage, systemic complications, and high treatment burdens, including prolonged hospitalisation and surgery.

• In this Lebanese cohort, most patients were young males, and upper extremities were the most frequently affected areas.

• High‐voltage injuries and third‐degree burns were common, contributing to significant morbidity and a 10% mortality rate.

• Nearly half of the patients developed infections, with Acinetobacter and Pseudomonas aeruginosa being the most common pathogens.

• This study provides rare national data and highlights the urgent need for prevention strategies, occupational safety measures, and multidisciplinary burn care in Lebanon.

1. Introduction

Electrical burns are considered to be a distinctive and severe form of burn injuries that result from the passage of electric current through the body, leading to extensive tissue damage, both internally and externally, and often affecting the skin, muscles, nerves, and other vital organs [1]. With the advancement in technology and the increased usage of electricity and electric devices nowadays, electric burn injuries have become more prevalent [2]. These injuries are defined as a form of mechanical trauma that occurs as a result of a low‐voltage (< 1000 V) or high‐voltage (> 1000 V) current and are often associated with an increase in morbidity and mortality [3]. Notably, these types of injuries are considered to be accidental in almost all cases, yet preventable. With a predominant impact on males, electrical injuries are frequently associated with occupational settings, and rank as the fourth leading cause of traumatic work‐related fatalities [4]. On the other hand, children can also be subject to electrical injuries within household settings [5]. However, electric injuries can cause either serious external burns or internal burns affecting the bones and muscles [6], in addition to both physical and psychological sequelae in the short‐ and long‐term [7].

Divided into four types, electrical injuries are either known as flash injuries—resulting from an arc flash and leading to superficial burns due to the inability of the current to penetrate beyond the skin [8], flame injuries—occurring when an arc flash catches a person's clothing with a potential of traversing the skin [9], lightning injuries—usually characterised by extremely brief yet high‐voltage electrical energy and involving electrical current coursing through the entire individual's body [10], and true electrical injuries—occurring when an individual becomes a part of an electrical circuit with an entrance and an exit site [1]. Moreover, it is worth noting that low‐voltage electrical current can be as serious as high‐voltage current, causing significant harm, and this is conditioned by the duration of exposure, the individual's size, and the area in contact with the electrical source [3, 11].

Furthermore, macroscopic and microscopic vascular damage can occur instantaneously and are frequently irreparable. Electrical exposure can induce heart arrhythmias and severe damage to other organ systems [12]. Hence, tissue resistance to electricity diminishes in the following order: bone, fat, tendon, skin, muscle, vein, and nerve. Bone heats to elevated temperatures, incinerating adjacent tissues, like muscles, resulting in muscular oedema and compartment syndrome in high‐voltage electrical traumas [13]. Thus, the entry and exit wounds are also to be considered in such injuries to ascertain which extremities require vigilant observation for compartment syndrome [1].

In Lebanon, to our best knowledge, there is a scarcity of comprehensive national data on burn injuries, particularly electrical burns. The absence of a centralised burn registry in Lebanon and the limited epidemiological studies can further hinder the ability to assess the burn that electrical burns have on the national level. The latest available data dates back to 2018, where Abou Dagher et al. showed that 4.1% of hospital admissions in a university hospital in Beirut–Lebanon were due to electrical burns [14]. Sooner, in 2013, Ghanimé et al. showed that 6.9% of hospital admissions in Geitaoui Hospital were due to electric burns [15]. This lack of data is concerning, especially as occupational hazards and infrastructure challenges in Lebanon can predispose individuals to such injuries [16].

For instance, Lebanon has been classified as an upper‐middle‐income developing country and has been dealing with a multitude of complex crises since the beginning of 2019, including the economic collapse, the political instability, the armed conflicts, the degradation in the infrastructure, and the explosion of Beirut's Port in 2020 [17]. The repercussions of these events on the Lebanese healthcare sector were no exception, especially with the shortages in medical supplies, workforce attrition, and the reduced operational capacities, which have strained emergency and specialised medical services, including burn care units [18]. However, it is worth mentioning that the only specialised burn care unit in Lebanon is located at the Lebanese Hospital Geitaoui—UMC in Beirut [19].

Therefore, given the above‐mentioned circumstances, there is an urgent need to investigate the epidemiological trends and clinical effects of electrical burns in Lebanon. Hence, the main objective of this study is to assess the prevalence and characteristics of electrical burns in the specialised burn care unit in Geitaoui Hospital in Lebanon. Specifically, this study aims to analyse the demographic characteristics, burn severity, hospitalisation outcomes, complications, and treatment modalities of patients admitted with electrical burns at Geitaoui Hospital. Secondary objectives include the identification of the most common anatomical sites affected, the patterns of infection and microbial isolates, the frequency and type of surgical interventions, as well as the evaluation of the trends in key laboratory biomarkers during hospitalisation. To address this, the present study was conducted using a retrospective approach, including available data from the first of January 2011 to 31st December 2024.

2. Methodology

2.1. Study Design

This study is a retrospective observational analysis conducted at Geitaoui Hospital in Lebanon, examining patients admitted with electrical burns between 2011 and 2024. The study aims to assess the demographic characteristics, burn severity, hospitalisation outcomes, complications, and treatment modalities associated with electrical burn injuries. The study protocol was reviewed and approved by the Ethical Committee of the Geitaoui Hospital under the code “2025‐IRB‐07” and the confidentiality of patient data was strictly maintained throughout the research.

2.2. Study Setting

The Geitaoui Hospital is a University Medical Center and a tertiary care hospital located in Beirut, Lebanon. This hospital includes the country's only specialised burn care unit, which operates, since May 1992, with the surgical department and serves as a national referral for all burn injuries in the country. This burn unit, being a part of the Geitaoui Hospital, is formed of a total of nine beds, used either as intensive care unit beds for critical burn cases or standard and post‐care beds for stabilised cases. Moreover, the centre manages both adult and paediatric cases of burn injuries and the admission criteria are based on the severity of burns and the systemic involvement. Upon admission, patients undergo a clinical evaluation in the emergency department where the total body surface area (TBSA) is evaluated. Then, when admitted to the burn care unit, a reevaluation and a reassessment are performed in order to apply the burn management protocol (available upon request).

2.3. Study Population

The study population included all patients, both paediatric and adult, diagnosed with electrical burns and admitted to Geitaoui Hospital during the 13‐year study period.

2.4. Eligibility Criteria

2.4.1. Inclusion Criteria

• Patients of all ages and genders diagnosed with electrical burns.

• Patients admitted to Geitaoui Hospital directly from the site of accident between 2011 and 2024.

• Patients with complete medical records documenting burn characteristics, hospitalisation details, and treatment received.

2.4.2. Exclusion Criteria

• Patients with non‐electrical burn injuries (e.g., thermal or chemical burns).

• Patients with incomplete or missing medical records are preventing full data extraction.

• Patients who were treated in the emergency department but not admitted to the hospital.

2.5. Data Collection

Data were collected retrospectively from patient medical records and hospital databases, including all admissions with electrical burns between January 1, 2011, and December 31, 2024. A standardised data collection form was utilised to extract patients' information and to ensure consistency. Collected data was anonymised before its analysis to ensure confidentiality and respect for patients included in the study.

2.6. Study Variables

The study variables encompassed multiple domains to comprehensively assess the characteristics and outcomes of electrical burn patients. The primary outcome was to evaluate the severity of burns and overall hospitalisation outcomes, including the degree of burns, TBSA affected, length of stay (LOS), and discharge status. Secondary outcomes included the occurrence of systemic complications (cardiac, neurologic, and renal), the need for intubation, presence and characteristics of infections, surgical interventions, and relevant laboratory findings.

Demographic variables included age, sex, and nationality. Burn characteristics covered the degree of burns, TBSA affected, anatomical location, voltage exposure (low or high), place of accident, and the entry and exit points of the electrical current. Hospitalisation outcomes comprised LOS, intubation status, discharge status, and complications involving the cardiac, neurologic, and renal systems. Infection‐related data included the presence of infection, the number and location of infection sites, and the identification of microbial isolates. Surgical interventions were categorised based on the procedures performed, including escharotomy, fasciotomy, debridement, skin grafting, flap procedures, and amputations. Lastly, laboratory findings encompassed white blood cell (WBC) count, liver function tests (including alanine aminotransferase (ALT) and aspartate aminotransferase (AST), haemoglobin (Hb), creatinine (Crea), blood urea nitrogen (BUN), and creatine kinase (CK) levels, recorded both at admission and on day five of hospitalisation).

2.7. Data Analysis

Data analysis was performed using IBM SPSS Statistics (version 26.0). Descriptive statistics were utilised to summarise patient characteristics and study variables. Categorical variables were expressed as frequencies and percentages, while continuous variables were reported as means and standard deviations (SD) for normally distributed data and medians with interquartile ranges (IQR) for skewed data. Comparative statistical analyses were not performed, as the study aimed to provide a descriptive overview of the patient population and their clinical outcomes.

3. Results

Between January 1, 2011, and December 31, 2024, a total of 1907 patients were admitted to the burn care unit at Geitaoui Hospital. Among them, 36 patients (1.9%) were identified as having electrical burn injuries. After applying the eligibility criteria, 6 patients were excluded due to incomplete medical records. As a result, a total of 30 patients were included in the final analysis. The following results summarise the findings from 30 patients with electrical burns admitted to Geitaoui Hospital between 2011 and 2024.

3.1. Demographics

The demographic analysis of patients with electrical burns indicates a significant male predominance, with 96.7% of cases (n = 29) occurring in males. The mean age of patients was 29.6 years (SD = 13.84), with a median of 25 years, suggesting that electrical burns predominantly affect young adults. The majority of cases (n = 26; 86.7%) were adults aged 18 years and above, while 13.3% were minors (Table 1).

TABLE 1.

Demographic characteristics of Burn patients.

		Frequency	Percent
Sex	Male	29	96.7
	Female	1	3.3
Age	Analysed N	30
	Mean (SD)	29.60 (13.84)
	Median (IQR)	25.00 (19.75–43.25)
	Min−Max	10.0–57.0
Age	< 18 years	4	13.3
	≥ 18 years	26	86.7
Nationality	Lebanese	22	73.3
	Syrian	6	20.0
	Others	2	6.7

Regarding nationality, Lebanese patients comprised 73.3% (n = 22) of the sample, followed by Syrians (n = 6; 20.0%) and other nationalities (n = 2; 6.7%). This distribution reflects the demographic composition of the hospital's patient population and suggests a potential occupational risk factor.

3.2. Burn Related Characteristics

The burn‐related characteristics of patients with electrical burns indicate that the majority of cases (n = 21; 70.0%) involved third‐degree burns, while 23.3% (n = 7) had mixed second‐ to third‐degree burns, and only 6.7% (n = 2) sustained second‐degree burns (Table 2).

TABLE 2.

Burn related characteristics among patients.

		Frequency	Percent
Degree	Second degree	2	6.7
	2nd to 3rd degree	7	23.3
	Third degree	21	70.0
TBSA%	Analysed N	30
	Mean (SD)	19.90 (17.40)
	Median (IQR)	15.00 (10.00–26.25)
	Min−Max	1.0–70.0
TBSA%	< 10%	5	16.7
	10%–30%	20	66.7
	> 30%	5	16.7
Localization	Upper extremities	28	93.3
	Lower extremities	19	63.3
	Head and neck	10	33.3
	Trunk	10	33.3
Voltage (high/low)	Low	4	13.3
	High	15	50.0
	Missing	11	36.7
Place of accident	Domestic	5	16.7
	Road	4	13.3
	Workplace	2	6.7
	Missing	19	63.3
Entry point	Hand	25	83.3
	Forearm	1	3.3
	Buttocks	2	6.7
	Trunk	1	3.3
	Foot	1	3.3
Exit point	Hand	7	23.3
	Head	3	10.0
	Forearm	1	3.3
	Trunk	1	3.3
	Foot	10	33.3
	Leg	8	26.7

The extent of burns, measured by TBSA, had a mean of 19.9% (SD = 17.40), with a median of 15% and an IQR of 10.00% to 26.25%. Most patients (n = 20; 66.7%) had burns covering 10% to 30% of their TBSA, while 16.7% (n = 5) had minor burns (< 10%) and another 16.7% (n = 5) had extensive burns (> 30%) (Figure 1).

FIGURE 1.

Distribution of patients as per the TBS categories.

The most frequently affected anatomical regions were the upper extremities (n = 28; 93.3%), followed by the lower extremities in 19 patients (63.3%), head and neck (33.3%), and trunk (n = 10; 33.3%). Regarding voltage exposure, half of the cases (n = 15; 50.0%) were attributed to high‐voltage injuries, while 13.3% (n = 4) involved low‐voltage exposure, with missing data in 36.7% of cases (n = 11) (Table 2).

Accidents most commonly occurred in domestic settings (n = 5; 16.7%), followed by road‐related incidents (n = 4; 13.3%) and workplace injuries (n = 2; 6.7%), though the location of the incident was unreported in 63.3% (n = 19) of cases. Entry points were most frequently the hand (n = 25; 83.3%), with a few cases involving the forearm (n = 1; 3.3%), buttocks (n = 2; 6.7%), trunk (n = 1; 3.3%), and foot (n = 1; 3.3%). Exit points varied, with the foot being the most common (n = 10; 33.3%), followed by the leg (n = 8; 26.7%), hand (n = 7; 23.3%), head (n = 3; 10.0%), forearm (n = 1; 3.3%), and trunk (n = 1; 3.3%) (Table 2).

3.3. Hospitalisation and Discharge

The hospitalisation and discharge outcomes of patients with electrical burns reveal a discharge rate of 90.0% (n = 27), while 10.0% of cases resulted in mortality due to multiple organ failure or sepsis. LOS varied significantly, with a mean duration of 25.69 days (SD = 26.55) and a median of 17 days, ranging from 1 to 99 days.

Intubation was required in 23.3% (n = 7) of patients, reflecting the severity of certain cases. Complications were observed in a subset of patients, with cardiac involvement occurring in 16.7% (n = 5) of cases. Among these, ischaemia and cardiac arrest each accounted for 40.0% (n = 2) of cases, while arrhythmia was noted in 20.0% (n = 1). Neurologic complications were reported in 10.0% of patients (n = 3), including craniotomy (n = 1; 33.3%) and cerebrospinal fluid (CSF) leakage with facial paralysis (n = 2; 66.7%). Renal complications were rare, with only one patient (n = 1; 3.3%) experiencing renal involvement (Table 3).

TABLE 3.

Hospitalisation and discharge related characteristics among electrical burn patients.

		Frequency	Percent
Discharge status	Discharged	27	90.0
	Dead	3	10.0
LOS	Analysed N	29
	Mean (SD)	25.69 (26.55)
	Median (IQR)	17.00 (5.50–41.50)
	Min−Max	1.0–99.0
Intubation	No	23	76.7
	Yes	7	23.3
Complications
Cardiac involvement	No	25	83.3
	Yes	5	16.7
Types of cardiac involvement	Arrhythmia	1	20.0
	Ischemia	2	40.0
	Cardiac arrest	2	40.0
Neurologic involvement	No	27	90.0
	Yes	3	10.0
Types of neurologic involvement	Craniotomy	1	33.3
	CSF leak and Facial Paralysis	2	66.7
Renal involvement	No	29	96.7
	Yes	1	3.3

3.4. Infection

The infection‐related characteristics among electrical burn patients indicate that 43.3% of patients (n = 13) developed infections during their hospitalisation (Table 4). Among those with infections, the majority (n = 9; 69.2%) had a single infection site, while 7.7% (n = 1) had two sites, and 23.1% (n = 3) had infections in three different locations (Figure 2).

TABLE 4.

Infection related characteristics among electrical burn patients.

		Frequency	Percent
Infection	No	17	56.7
	Yes	13	43.3
Number of infection sites	1	9	69.2
	2	1	7.7
	3	3	23.1
Infection site	Blood	5	16.7
	Wound	8	26.7
	Sputum	2	6.7
	Urine	1	3.3
	Central line	2	6.7
Infection germ	MRSA	4	13.3
	Acinetobacter	6	20.0
	Pseudomonas aeruginosa	5	16.7
	Klebsiella pneumoniae	2	6.7
	E. Coli AmpC	3	10.0

FIGURE 2.

Distribution of patients as per the infection site.

The most frequently affected infection site was burn wounds (n = 8; 26.7%), followed by bloodstream infections (n = 5; 16.7%), central line‐associated infections (n = 2; 6.7%), and urinary tract infections (n = 1; 3.3%). The microbiological analysis revealed that Acinetobacter was the most commonly isolated pathogen (n = 6; 20.0%), followed by Pseudomonas aeruginosa (n = 5; 16.7%), methicillin‐resistant Staphylococcus aureus (MRSA) (n = 4; 13.3%), Escherichia coli producing Ampicillin C beta‐lactamase ( E. coli AmpC) (n = 3; 10.0%), and Klebsiella pneumoniae (n = 2; 6.7%) (Figure 3).

FIGURE 3.

Distribution of patients as per the infection germ.

3.5. Electrocardiogram and Laboratory Findings

All patients had normal electrocardiogram (ECG) findings at admission.

The laboratory findings among the electrical burn patients reveal significant variations in key biomarkers over the course of hospitalisation (Table 5).

TABLE 5.

Laboratory findings among electrical burn patients.

WBC at admission	Analysed N	29
	Mean (SD)	15732.41 (6452.58)
	Median (IQR)	16900.00 (9900.00–21070.00)
	Min−Max	4800.0–29400.0
WBC at D5	Analysed N	24
	Mean (SD)	9739.17 (3752.08)
	Median (IQR)	8950.00 (6050.00–13150.00)
	Min−Max	3700.0–17600.0
ALT at admission	Analysed N	17
	Mean (SD)	70.24 (72.57)
	Median (IQR)	43.00 (12.50–134.50)
	Min−Max	9.0–271.0
ALT at D5	Analysed N	3
	Mean (SD)	126.00 (63.51)
	Median (IQR)	113.00 (70.00 ‐ NA)
	Min−Max	70.0–195.0
AST at admission	Analysed N	16
	Mean (SD)	266.38 (434.66)
	Median (IQR)	39.50 (24.00–336.25)
	Min−Max	19.0–1609.0
AST at D5	Analysed N	3
	Mean (SD)	252.33 (78.36)
	Median (IQR)	293.00 (162.00 ‐ NA)
	Min—Max	162.0–302.0
HB at admission	Analysed N	29
	Mean (SD)	15.26 (1.80)
	Median (IQR)	14.80 (13.90–16.60)
	Min−Max	10.6–19.1
HB at D5	Analysed N	24
	Mean (SD)	12.20 (1.67)
	Median (IQR)	11.90 (11.05–13.65)
	Min−Max	9.1–15.2
Creatinine at admission	Analysed N	28
	Mean (SD)	0.77 (0.18)
	Median (IQR)	0.80 (0.67–0.89)
	Min−Max	0.4–1.1
Creatinine at D5	Analysed N	23
	Mean (SD)	0.82 (0.67)
	Median (IQR)	0.70 (0.61–0.87)
	Min−Max	0.3–3.8
BUN at admission	Analysed N	26
	Mean (SD)	13.12 (3.57)
	Median (IQR)	13.00 (10.00–16.00)
	Min−Max	6.0–21.0
BUN at D5	Analysed N	20
	Mean (SD)	14.80 (13.60)
	Median (IQR)	11.00 (8.00–17.00)
	Min−Max	6.0–69.0
CK level at admission	Analysed N	24
	Mean (SD)	13635.46 (24490.69)
	Median (IQR)	2333.00 (306.50–22433.00)
	Min−Max	52.0–104000.0
CK level at D5	Analysed N	16
	Mean (SD)	2261.25 (2811.47)
	Median (IQR)	918.00 (381.25–3360.50)
	Min−Max	55.0–8583.0

WBC counts were notably elevated at admission, with a mean of 15732.41/mm³ (SD = 6452.58) and a median of 16 900/mm³, indicating an acute systemic inflammatory response. By day 5, WBC levels showed a substantial decline, with a mean of 9739.17/mm³, suggesting a gradual resolution of the inflammatory response in most patients.

Liver function markers were markedly elevated at admission, particularly AST, which had a mean of 266.38 U/L (SD = 434.66), reflecting potential hepatic or muscular injury. While AST levels remained high at day 5, ALT showed an increasing trend, possibly due to ongoing hepatic stress or systemic injury progression.

Hb levels at admission were relatively high, with a mean of 15.26 g/dL (SD = 1.80), but declined significantly by day 5 (mean = 12.20 g/dL), likely due to fluid resuscitation, haemodilution, or ongoing blood loss secondary to burn injury management.

Renal function markers, Crea and BUN, remained within normal ranges at admission, with minimal variations over time. However, a few cases showed elevated crea levels by day 5; yet, these fluctuations do not represent renal involvement, showing that this might be due to the hydration status of the patient, the treatment he is taking, or laboratory discrepancies.

CK levels at admission were significantly elevated, with a mean of 13635.46 U/L (SD = 24490.69) and a median of 2333 U/L, indicating severe muscle damage, consistent with electrical burns' deep tissue involvement. By day 5, CK levels had decreased markedly (mean = 2261.25 U/L), reflecting ongoing muscle recovery, although some patients exhibited persistently high values, necessitating close monitoring for rhabdomyolysis and related complications.

3.6. Surgical Treatment

The analysis of surgical treatment modalities indicates that 63.3% of patients underwent surgical intervention, while 36.7% were managed without surgery (Table 6). Among those who required surgical procedures, skin grafting was the most commonly performed intervention (36.7%), followed by debridement (26.7%), fasciotomy (20.0%), and escharotomy (6.7%). More advanced reconstructive procedures, including flap coverage, were necessary in 13.3% of cases. Notably, amputation was required in 20.0% of patients, highlighting the severity and extent of deep tissue damage associated with electrical burns (Figure 4).

TABLE 6.

Surgical treatment modalities among electrical burn patients.

		Frequency	Percent
Surgical treatment	No	11	36.7
	Yes	19	63.3
Types of surgical treatment	Escharotomy	2	6.7
	Fasciotomy	6	20.0
	Skin graft	11	36.7
	Debridement	8	26.7
	Flap	4	13.3
	Amputation	6	20.0

FIGURE 4.

Distribution of patients as per the surgical treatment modalities.

4. Discussion

Amidst the fact that electrical injuries account for a small percentage of the total admissions in hospitals, burn centres and emergency departments, these injuries can have serious effects on both physical and psychological outcomes in electrocuted patients. For instance, Albayrak et al. have found that 5.3% (57 out of 1079 patients) of the admissions in the burn centre in Turkey, a Middle Eastern country, were caused by electrical injuries [20]. In our study, the results revealed that, within a period of 12 years, the total number of admissions in the burn centre in Geitaoui hospital was 30 patients. These findings are concordant with the international literature from other developing countries and middle‐income countries. For instance, according to Kurt et al. (2016), 94 patients were admitted in a tertiary hospital in Turkey between the years 2008 and 2012 for electrical burns, where 50% (n = 47) had high‐voltage burns with a mean TBSA score of 21.8 and a length of stay of 21.3 days, 44.7% (n = 42) had low‐voltage burns with a mean TBSA of 8.6% and a length of stay of 8.6 days, and the remaining 5.3% (n = 5) had flash burns. Therefore, these burns were associated with soft tissue lacerations, major bone fractures, epidural hematomas, and infections [21]. Similarly, in Portugal, Brando et al. (2017) mentioned the admission of a total of 1695 patients for different types of burns with 5.84% (n = 99) suffering from electrical burns of high voltage (n = 30; 30.3%) and low voltage (n = 24; 24.2%) [22]. Moreover, the authors found that high‐voltage burns were significantly associated with elevated TBSA, mean length of stay, and serum CK levels (p < 0.001) [22]. In Pakistan, Saaiq (2016) showed that 85 children were admitted to the Burn Care Centre between the years 2008 and 2012, with 71.76% (n = 61) suffering from high‐voltage burns and an associated mortality rate of 2.35% (n = 2) among all admitted children [23]. In Iran, Salehi et al. showed a higher prevalence of electric burns, where 202 patients were admitted to Motahari Hospital between March 2011 and June 2012. Moreover, the authors found that 52% (n = 105) of the cases were construction workers who manifested more severe complications than other admitted patients, including limb amputation and fasciotomy [24]. In a more recent study, Al‐Benna mentioned 82 cases of electrical burns consulting a tertiary burn centre in the United Arab Emirates. Among the cases, 92.7% (n = 76) were males, with 78% (n = 64) involved in low‐voltage burns and 22% (n = 18) involved in high‐voltage burns, with a mean TBSA of 2.9% and a mean length of stay of 2.3 days [25]. As per the treatment modalities, 53% (n = 43) benefited from conservative treatment, 19% (n = 16) underwent excision and split skin grafting, 7% (n = 6) underwent surgical decompression alongside excision and split grafting, and 20% (n = 17) required wound coverage [25]. These comparative findings reflect the varying severity and outcomes of electrical burns, likely affected by the voltage exposure, the safety regulations, the capacity of the healthcare system, as well as the timely access to care.

Delving into the characteristics of the patients, the results found that there is a predominance of male gender, with 96.7% of the total number of patients admitted for electrical injuries. This result indicates that the male predominance in such accidents is similar to the literature, where different studies assessed also showed that electrical burns are more prevalent in male individuals when compared to their female counterparts [14, 15, 20, 22]. This result might indicate that males are generally more involved in jobs necessitating a direct interaction with electrical systems, like construction, engineering, and maintenance tasks, which carry an increased risk of exposure to electrical hazards [26], causing in the majority of cases (50%) high‐voltage contacts. Hence, the severity and prevalence of third‐degree burns (70%) emphasise the critical nature of these incidents, especially as in Lebanon, there is a lack of safety infrastructure when it comes to electricity, due to the lack of available resources and the availability of strict policies and safety protocols [27]. Therefore, this result is consistent with the fact that high‐voltage injuries usually result in more severe burn outcomes due to the penetration of energy and its transmission within the human body [1]. Moreover, it is worth noting that the average age of patients presented with electrical burns was shown to be equal to 29.6 years, indicating the engaging and demanding nature of jobs that necessitate the intervention of younger individuals who still have physical ability and energy. For instance, the literature shows that the majority of electrical injuries occur in individuals aged between 18 and 40 years [28], identifying young adults in the working age at a higher risk of these types of injuries, which explains their predominance in our study population.

Notably, electrical burns were shown to be the most common in upper extremities (93.3%), followed by lower extremities (63.3%), which highlights that direct contact areas during electrical incidents are usually the most affected part. For instance, the literature shows that the majority of electrical injuries affect ankles and wrists [29], with the hands (83.3%) being the most affected parts due to direct contact with electrical sources during manually handled activities [1]. Moreover, the majority of the accidents reported occurred in domestic settings (16.7%), followed by road‐related incidents (13.3%), and workplace injuries (6.7%). However, the location of the accident was not documented in 63.3% of the cases, which raises concerns about the completeness of the history taken during the admission of burn patients. However, this high percentage of unknown locations could mask the reality and the true burden of occupational injuries, particularly in informal or undocumented work environments. On the other hand, several studies have reported high incidence of electrical injuries in the workplace, which contradicts the results of our study. In this regard, a study conducted by Ding et al. in China found that 31.38% of the electrical burn patients were industrial workers, and 20.74% were electricians, which indicates that over half of the cases were occupationally related [30]. In the same regard, another study conducted in India by Kamle and Kshirsagar reported that the majority of the electrical burn injuries occur in work‐related conditions, specifically affecting individuals working in the electricity field, industrial field, agriculture, or construction field [31].

Overall, results show that around 10% to 30% of the TBSA in individuals with electrical burns is affected, which indicates a moderate severity of the injuries, also explained by the high rates of discharge from the hospital after surveillance and treatments (90%), with an average LOS of 25.69 days. Therefore, there remains a high mortality associated with electrical burns (10%), showcasing the serious effect of electrical burn and its high risk of mortality mentioned previously in the literature. However, the mortality rates observed in the Lebanese settings are shown to be higher than those mentioned in China (0.46%) [30], Iran (0.32% for high‐voltage burns and 0.01 for low‐voltage burns) [32], yet lower than those mentioned in Brazil (11.7%) [33] and in a previously conducted study in Lebanon (18%) [15].

Furthermore, several complications were associated with electric burns, noting intubation (23.3%), cardiac involvement (16.7%), neurological complications (10%), and renal involvement (3.3%). Moreover, a significant infection rate was observed (43.3%), most commonly being infections of the burn wounds (26.7%), due to Acinetobacter (20%), Pseudomonas aeruginosa (16.7%), MRSA (13.3%), E. coli (10%), and Klebsiella pneumoniae (6.7%). As well, these complications were shown to be responsible for different perturbations in blood biomarkers, such as elevation in WBC, ALT, AST, CK, Hb, and others. These results highlight the complex physiopathology of electrical injuries, reflecting the systemic impact of electrical current on different organ functions [1, 22, 28] and the extensive tissue damage that can be caused by electrical burns, reaching hepatic, renal, and muscular sites [34].

As per the management of electrical burns, it was shown that the majority of the patients received surgical treatment (63.3%), where skin grafting was the most common (36.7%). Hence, skin grafting, usually used for closing extensive burn wounds, is known to promote healing alongside minimising the infection risks in burned patients. This treatment approach is extensively known to be efficient in helping restore both aesthetic and functional outcomes of the burned sites, through providing barriers and facilitating skin growth which reduces scars [35, 36].

5. Strengths and Limitations of the Study

The present study has several strengths to be mentioned. For instance, this study included data of a 13‐year period which makes it the longest retrospective analysis of electrical burn cases in Lebanon, especially since only two studies have tailored this topic, noting Abou Dagher et al. and Ghanimé et al. [14, 15]. Additionally, this is the first study in Lebanon that focused exclusively on electrical burns in a specialised national burn unit and this has provided insightful epidemiological and clinical data to the Lebanese nation. Moreover, the study included detailed laboratory trends, surgical interventions, and infection profiles that offered a more comprehensive overview of the clinical presentation of electrical burn patients. As well, this study can provide a critical reference point for countries suffering from similar healthcare challenges and economic conditions.

On the other hand, the study has also some limitations. First, the sample size was relatively small, which might limit the generalisability of our results. Therefore, this study included patients who have presented for medical care due to burn injuries. Yet, some patients not seeking medical assistance might not be taken into consideration. In addition, the restricted sample size might have limited our ability to test correlations and associations between different variables. Second, the study relied on a retrospective approach, and throughout the data collection, we have faced some missing data, which might have introduced information bias. Third, considering that all patients with electrical burn injuries are at risk of developing cardiac complications, this study lacked the assessment of cardiac enzyme measurements; only ECGs were examined. Finally, due to its uni‐centric approach, this study lacked the potential to assess the long‐term effect of electrical burns on patients, either on the physical or psychological perspectives.

6. Conclusion

The present study constituted a piece of evidence regarding electric burns in Lebanon. This 13‐year retrospective study provided critical insights into the demographic and clinical patterns of electrical burns in Lebanon, revealing a high incidence of deep tissue damage, extended hospitalisations, and surgical interventions, particularly among young adult males. Therefore, the high infection rate and mortality highlight the urgent need to strengthen national preparedness and occupational safety measures, particularly in low‐resource environments that are affected by the systemic challenges in the healthcare sector. Hence, given the absence of the national burn registry and the limited data available regarding burn cases, the results of our study call for the establishment of standardised data collection systems and more inclusive treatment protocols. Future research is needed, focusing on including multi‐centric prospective studies to be able to better assess the national trends and improve the evidence base for policy development and clinical guidelines in similar middle‐income countries.

Ethics Statement

The study was examined and approved by the Institutional Review Board (2025‐IRB‐07) of the Lebanese Geitaoui Hospital–UMC. Participants' confidentiality and anonymity were maintained throughout the study to preserve their privacy. All data were securely maintained and accessed from patients' medical records only by authorised persons, conforming to ethical standards and procedures.

Conflicts of Interest

The authors declare no conflicts of interest.

Moukawam E., Aoun C. B., Sfeir J., et al., “Electrical Burns: A Retrospective Study at the Lebanese Burn Center in Geitaoui Hospital, Lebanon (2011–2024),” International Wound Journal 22, no. 8 (2025): e70732, 10.1111/iwj.70732.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.