Abstract
Patients sustaining high-voltage electrical burns involving the upper extremities were evaluated for deep muscle compartment necrosis by early surgical exploration. Following resuscitation, patients were taken to the operating room where mandatory exploration of volar and extensor forearm and hand compartments was done to evaluate muscle viability. It was observed that deep muscle layers sustained the greatest thermal injury and that extended fasciotomies were required to obviate compartment syndrome and the potential for continued ischemia. Although 10 emergency amputations were required for six patients, those who underwent extensive exploration of their forearms and hands did not require subsequent amputation for nonviable extremities during second-look operations. These observations support the role for early exploration with generous exposure of deep muscle compartments to access and treat the thermal injury that results from high-voltage burns.
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Selected References
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- Ahrenholz D. H., Schubert W., Solem L. D. Creatine kinase as a prognostic indicator in electrical injury. Surgery. 1988 Oct;104(4):741–747. [PubMed] [Google Scholar]
- Chilbert M., Maiman D. J., Ackmann J. J., Brown C., Henderson J. D., Jr, Prieto T., Darin J., Swiontek T., Myklebust J., Sances A., Jr Determination of tissue viability in experimental electrical injuries. J Burn Care Rehabil. 1990 Nov-Dec;11(6):516–525. doi: 10.1097/00004630-199011000-00006. [DOI] [PubMed] [Google Scholar]
- Chilbert M., Maiman D., Sances A., Jr, Myklebust J., Prieto T. E., Swiontek T., Heckman M., Pintar K. Measure of tissue resistivity in experimental electrical burns. J Trauma. 1985 Mar;25(3):209–215. doi: 10.1097/00005373-198503000-00007. [DOI] [PubMed] [Google Scholar]
- DiVincenti F. C., Moncrief J. A., Pruitt B. A., Jr Electrical injuries: a review of 65 cases. J Trauma. 1969 Jun;9(6):497–507. [PubMed] [Google Scholar]
- Holliman C. J., Saffle J. R., Kravitz M., Warden G. D. Early surgical decompression in the management of electrical injuries. Am J Surg. 1982 Dec;144(6):733–739. doi: 10.1016/0002-9610(82)90560-8. [DOI] [PubMed] [Google Scholar]
- Hunt J. L., Heck E. L. Identification of nonviable muscle in electric burns with nitroblue tetrazolium. J Surg Res. 1984 Nov;37(5):369–375. doi: 10.1016/0022-4804(84)90202-6. [DOI] [PubMed] [Google Scholar]
- Hunt J., Lewis S., Parkey R., Baxter C. The use of Technetium-99m stannous pyrophosphate scintigraphy to identify muscle damage in acute electric burns. J Trauma. 1979 Jun;19(6):409–413. doi: 10.1097/00005373-197906000-00004. [DOI] [PubMed] [Google Scholar]
- Quinby W. C., Burke J. F., Trelstad R. L., Caulfield J. The use of microscopy as a guide to primary excision of high-tension electrical burns. J Trauma. 1978 Jun;18(6):423–431. doi: 10.1097/00005373-197806000-00007. [DOI] [PubMed] [Google Scholar]
- Robson M. C., Murphy R. C., Heggers J. P. A new explanation for the progressive tissue loss in electrical injuries. Plast Reconstr Surg. 1984 Mar;73(3):431–437. doi: 10.1097/00006534-198403000-00017. [DOI] [PubMed] [Google Scholar]
- Wilkinson C., Wood M. High voltage electric injury. Am J Surg. 1978 Dec;136(6):693–696. doi: 10.1016/0002-9610(78)90337-9. [DOI] [PubMed] [Google Scholar]
- Zelt R. G., Daniel R. K., Ballard P. A., Brissette Y., Heroux P. High-voltage electrical injury: chronic wound evolution. Plast Reconstr Surg. 1988 Dec;82(6):1027–1041. doi: 10.1097/00006534-198812000-00014. [DOI] [PubMed] [Google Scholar]