VISCERAL INJURIES, WOUND-INFECTION AND SEPSIS FOLLOWING ELECTRICAL INJURIES

Visceral injuries, wound infection and sepsis were investigated in 226 inpatients who sustained electrical burns over a period of 15 years. Four patients who sustained thoracic and abdominal organ injuries were noted in this series. The patients had injuries of the small intestin e, stomach, colon and the lung. All the patients received operative tr eatment. Two of them died of sepsis. Injuries to the internal organs s hould always be considered following high-voltage injuries, and they s hould be managed as early as possible. The data concerning wound infec tion and sepsis following electrical injuries were evaluated in three consecutive 5-year periods. Over this period of 15 years, different an tibiotic regimens were used for prophylaxis and treatment. Most patien ts in the current series had been contaminated or infected by various pathogens prior to admission. Long-lasting administration of prophylac tic antibiotics in these patients showed no improvement in controlling the sepsis. After 1987, most of the microorganisms were eliminated fo llowing more effective antimicrobial therapy. The progressive decrease in infection frequency of species such as Pseudomonas aeruginosa, Pro teus mirabilis and Enterobacter cloacae, appeared to be causally relat ed to the changes in the general therapeutic protocol which included n ew antibiotics. The infections caused by E. coli and Staphylococcus au reus showed a rather steady slate. A marked increase in frequency of n egative wound cultures was also noted between the years 1989 and 1993. A gradual decrease in mortality rates was observed from the first to the last 5-year period, whereas mortality roles due to sepsis showed a gradual but slower decline. Sepsis (142 patients comprising 62.8 per cent of the total mortality rate) was the most frequent complication r esulting in death.