Lower trapezius myocutaneous flap repairs adjacent deep electrical burn wounds.

BACKGROUND: Local tissue damage caused by electrical burns is often deep and severe. High-voltage electrical burns are common in the head, neck and torso areas. These are mostly caused by direct contact with the power supply and are often accompanied by deep injuries of the nerve, blood vessel, muscle, tendon, and bone. We must pay great attention to the clinical treatment of these parts injured by electrical burn. CASE PRESENTATION: The first case involved a migrant worker who touched a 6-kV high-tension wire when welding steel; this electric shock caused burns in many places. Deep electrical burn wounds were mainly located on the left shoulder and back, characterized by widespread skin and soft tissue defect and bone necrosis. We utilized a lower trapezius myocutaneous flap to repair these wounds in the neck and back caused by deep electrical burns. The flap survived completely and the wound was effectively repaired. The function and shape of the shoulder and back after the restoration were satisfactory. The second case involved a 29-year-old who accidentally touched a high-voltage wire while working and was burned by a 30,000-V electric shock. His wounds were mainly located on the left head, neck, back and left upper limbs. We designed a 30 cm × 12 cm right trapezius myocutaneous flap which completely covered the wound surface; the electrical burn wounds on the neck and back were effectively repaired. After the electrical burn wound was repaired, the neck function returned to normal with a satisfactory shape. CONCLUSION: The authors report two cases of patients who were burned by high voltage. We used lower trapezius myocutaneous flaps to repair their wounds, which achieved satisfactory clinical results. This study has provided a reliable surgical method for the clinical treatment of deep electrical burn wounds in the neck, shoulders and back.

Anterior chest support, muscular activity and subjective rating of exertion during microtome sectioning.

Seven females, six laboratory assistants, participated in the experimental part of the study. The level of muscular activity in different sitting work postures was recorded, using surface electrodes, as full-wave-rectified and low-pass filtered EMG, and normalised. The laboratory assistants also rated the degree of exertion in four different body regions during their ordinary microtome sectioning work, comparing the use of anterior chest support with the use of their usual chair with lumbar support. The use of anterior chest support reduced the muscular activity in the lumbar back muscles but increased it in the shoulder muscles. Perceived exertion in the neck, shoulders and thoracic back regions increased. Anterior chest support does not seem to solve the problem of neck- and-shoulder load-elicited pain during the work of preparing laboratory sections.