ELECTRICAL INJURIES - MORBIDITY, OUTCOME AND TREATMENT RATIONALE

Electrical injuries are unique with respect to low mortality rates, bi ll very high rates of short- and long-term morbidity, and overall outc ome. Controversy still exists regarding the advantages of one-stage de bridement versus early serial debridement of necrotic tissue. The purp ose of this study was a retrospective evaluation of treatment, morbidi ty and outcome in a group of patients with electrical injuries. Over a 13-year period 1992 patients were admitted with acute burns to our bu rn centre. Electrical injuries occurred in 129 (6. 5 per cent) of hese patients. There were 38 high-tension injuries and 91 low-tension inju ries. The average age was 33.7 years (5 months to 63 years), with burn wounds ranging from 1 to 57 per cent total body surface area (mean 9. 5 per cent). Ninety-four (72.9 per cent) of these injuries were work r elated, and most occurred in males (85 per cent). A total of 323 surgi cal procedures were performed on those 129 patients. An average of 0.4 8 surgical debridements per patient was necessary in the low-tension i njury group and only three partial finger or toe amputations were nece ssary. In the high-tension group, 27 major limb amputations were perfo rmed after 2.3 debridements per patient, resulting in an overall major limb amputation rate of 35 per cent. The average length of stay was 2 2 days, and the cost of hospitalization ranged from $900 to $120 000 ( mean $14 907). Significant long-term neuroiogical deficits persisted i n 73 per cent of patients at long-term follow-up (mean 4.5 years). Onl y 5.3 per cent of patients after high-voltage electrical injury were a ble to return to their premorbid job.