ELECTRICAL BURN INJURY AMONG ADULTS:

EXPERIENCE AT PIMS, ISLAMABAD.

Presenter: Muhammad Saaiq
Authors:
Muhammad Saaiq , Hameed-ud-din, M.Ibrahim Khan,
DEPARTMENT OF PLASTIC & RECONSTRUCTIVE SURGERY, PIMS ,
ISLAMABAD, PAKISTAN
PIMS , ISLAMABAD.
Presented at:
IBCAST 2009 (International Bhurban Conference on Applied
Sciences and Technology ) Held at Centres of Excellence in Sciences
and Applied Technologies ( CESAT ), Islamabad.
Jan 19, 2009.
ELECTRICAL BURN INJURY
ELECTRICAL BURN INJURY

TYPES

¾ High Voltage Injuries

¾ Low Voltage Injuries

¾ Cloud to ground Lightning

ELECTRICAL BURN INJURY

PATHOPHYSIOLOGY

¾ Direct tissue damage from electrical energy.

¾ Conversion to thermal energy.

¾ Mechanical injuries.
ELECTRICAL BURN INJURY

FACTORS INFLUENCING THE SEVERITY

¾ Magnitude of Energy delivered

¾ Type of Current
¾ Pathway of the Current
¾Duration of Exposure
¾Others
ELECTRICAL BURN INJURY

CLINICAL PRESENTATION

• Skin burns
• Cardiac arrhythmias
• Renal failure
• Limb Compartment syndrome
• Others
ELECTRICAL BURN INJURY

MANAGEMENT OF THE VICTIM

• General Management
i.e ABCDEs
• Specific measures:
a) Medical measures
I.V Fluid resuscitation
IV Bicarbonate
IV Mannitol

b) Surgical measures:
Debridements
Fasciotomies
Amputations
Various Reconstructive Procedures.
 FACTORS INFLUENCING SEVERITY
Of EBI

A) Magnitude of Energy
delivered
FACTORS INFLUENCING SEVERITY
Of EBI
(Cont’d)

B) Type of Current
FACTORS INFLUENCING SEVERITY
Of EBI
(Cont’d)

C) Duration of Exposure
FACTORS INFLUENCING SEVERITY
Of EBI
(Cont’d)

D) Resistance Offered by the

Tissues
FACTORS INFLUENCING SEVERITY
Of EBI
(Cont’d)

E) Pathway of the Current

 CLINICAL PRESENTATION
of
ELECTRICAL BURN INJURY

• Skin burns / tissue trauma

• Cardiac arrhythmias
• Renal failure
• Limb Compartment syndrome
• Others
INVESTIGATIONS OF EBI VICTIM

• Basic essential tests

• ECG
• Urine for Myoglobin
• CK
• Others
MANAGEMENT OF EBI VICTIM

• General Management

• EBI specific measures

MANAGEMENT OF EBI VICTIM
(Cont’d)

GENERAL MEASURES INCLUDE:

• A
• B
• C
• D
• E
F?
EBI Specific Measures

a) Medical measures:
• I.V Fluid resuscitation
• IV Bicarbonate
• IV Mannitol
EBI Specific Measures
(Cont’d)

b) Surgical measures:
• Debridement
• Fasciotomies
• Amputations
• Reconstructive Procedures.
 ELECTRICAL BURN INJURY;
EXPERIENCE AT PIMS, ISLAMABAD.
Duration of the Study:Jan 01 2005 to June 30, 2007
Objective: To document the presentation and
outcome of Electrical burn Injury in our set up.
Study Design: Descriptive Study.
Place of the Study : Department of Plastic &
Reconstructive Surgery, PIMS, Islamabad.
Duration of the Study:Jan 01 2005 to June 30, 2007
Subjects and Methods: All adult Electrical burn
Injury victims presenting to the Department
and consenting to participate in the study.
Data Collection and Processing: Proforma
 Distribution of Burn Injuries Overall (n=561)

5.70% of the total Patients were of

Electrical Burn Injuries

Miscellaneous 13

Electrical 32

Chemical 81

Scalds 172

Flame burns 263

0 50 100 150 200 250 300

Causes of Electrical burn injury (n=32)

Contact with transformer 1

Contact with E. pole 1

Iatrogenic 3

Workplace accidents0 11

Household Accidents 16

0 5 10 15 20
NUMBER OF PATIENTS
 Gender Distribution (n=32)

Female
41%

Male
59%
 Age Distribution (n=32)
10
10 9
8
6
Number of 6 5
Patients 4

2 1 1
0
0-10 11 20 21 -30 31 -40 41 -50 51 -60
Age ( Years)
Voltage Distribution Of Electrical burn injury (n=32)

High
41%

Low
59%
Surgical Procedures Undertaken among the
Victims of Electrical burn injury ( n=70)

PROCEDURE NUMBER
1 Debridements 28
2 Amputations 15
3 STSGs 14
4 Flaps 7
5 Fasciotomies / Carpal 6
tunnel Release
Various Amputations Undertaken among the Victims
of Electrical burn injury (n=15)

AMPUTATION NUMBER

1 Upper Limb:
Right 6
Left 3

2 Hand 1

3 Finger(s) 5
 Associated Injuries found (n=4)

ASSOCIATED NUMBER
INJURIES

1 Long bone fracture 1

2 Spinal cord trauma 1

3 Mild head injury 2

4 Genital injury 1
Complications Encountered (n=8)

COMPLICATIONS NUMBER

1 Wound infection 5

2 Cardiac dysrhythmia 1

3 Renal failure 1

4 Sepsis 1
 Rate of Hospitalization : 71.87%

Average Hospital stay: 17 days ( Range

3-63 days)

Inhospital mortality: 01
Conclusion & Message