Knowledge, Attitudes, and Practices Regarding Electrical Burns.

Burn prevention programs can effectively reduce morbidity and mortality rates. In this article, we present the findings of our investigation of the knowledge, attitudes, and practices of the Saudi Arabian population regarding electrical burns. Our study was a cross-sectional online survey that used a five-part questionnaire to assess the participant's demographic information, knowledge of electrical burns, attitudes toward electrical injuries, and practices related to electrical burns and their prevention. Overall, 2314 individuals responded to the survey (males: 41.2%; females: 58.8%). A total of 839 participants (36%) had a personal or family history of electrical burns. Approximately ≥90% of the responses to questions on electrical burn-related knowledge were correct; relatively less responses to questions on the extent of tissue damage from electrical burns and arcs were correct (74% and 29%, respectively). Only 54% of the respondents knew that applying first aid to the burn-affected areas at home could lead to a better outcome; 27% and 19% did not know the correct answer and thought that this would not lead to a better outcome, respectively. The most common source of information was school or college (38.9%), followed by social media (20.8%) and internet websites (16.3%). Enhancing community awareness and practices related to electrical burns is a cost-effective and straightforward strategy to prevent the morbidity and mortality associated with electrical injuries.

Severe High-Voltage Electrical Injury: A Rare Case Report.

High-voltage electrical injury usually causes severe tissue damage and serious secondary complications. We report a case of treatment of severe high-voltage electrical injury. A series of personalized and effective treatment plans were created through repeated discussions, we successfully handled a series of acute and critical conditions, including severe limb damage, a very large area of full-thickness abdominal wall defect, abdominal viscera (stomach and liver) necrosis, abdominal infection, renal insufficiency, myocardial damage, and malignant arrhythmia (atrial fibrillation). Finally, the wounds were all closed, the functions of the abdominal organs were restored, and the course of the disease was successfully transitioned into the rehabilitation stage. It took a lot of twists and turns but ultimately saved the patient's life. The successful treatment of this patient provides an important reference for similar patients with serious electrical injury in the future.

[Pay more attention to the management of burn wounds of special causes and sites].

The treatment of burn wounds of special causes and sites is a very challenging clinical work. In this paper, we briefly discussed the incidence rates of chemical burns, electric burns, facial burns, hand burns, and perineal burns, as well as the complexity and severity of pathological injury of the corresponding wound tissue. In addition, we briefly discussed the main principles and methods of clinical treatment, as well as the difficult problems to be solved. It is hoped to attract attention and provide reference for further improving the overall treatment ability of burns.

Electrical burns in adults.

INTRODUCTION: Electrical burns account for up to 10% of burns admissions worldwide and are a potentially serious mechanism of injury. The aim of this study is to describe the epidemiology, presentation, management and complications of electrical burn injuries in adults. MATERIAL AND METHODS: A retrospective study of all adult patients with electrical burns admitted to a tertiary burns centre. RESULTS: Eighty-two cases were identified. The mean age was 40 ± 2 years, 92.7% were males. The most common activities causing the injuries were work (39%) and do-it yourself activities (32%). A low voltage (< 1,000 W) power source was involved in 78% of cases. The mean total body surface area involved was 3 ± 0.3%. The head, hands, and other upper extremities were the body parts most frequently injured. The mean hospital stay was 2 ± 1days. CONCLUSION: Electrical injury was an infrequent but potentially serious cause of injury in adults. Minor injuries were successfully managed non-operatively. Electrical burns in adults are mainly low voltage burns contracted by manual workers resulting in a flesh burn. Although rare, the loss of digits, neurological sequelae, cardiac arrhythmias and renal failure remain serious complications in a significant number of cases.

Electrical injuries and outcomes: A retrospective review.

Electrical burns (EI) differ from other burn injuries in the immediate treatment given and delayed sequelae they manifest. This paper reviews our burn center's experience with electrical injuries. All patients with electrical injuries admitted from January 2002 to August 2019 were included. Demographics; admission, injury, and treatment data; complications, including infection, graft loss, and neurologic injury; pertinent imaging, neurology consultation, neuropsychiatric testing; and mortality were collected. Subjects were divided into those who were exposed to high (>1000 volts), low (<1000 volts), and unknown voltage. The groups were compared. P < 0.05 was considered significant. One hundred sixty-two patients with electrical injuries were included. Fifty-five suffered low voltage, 55 high voltage, and 52 unknown voltage injuries. High voltage injuries were more likely to be male (98.2% vs. 83.6% low voltage vs. 94.2% unknown voltage, p = 0.015), to experience loss of consciousness (69.1% vs. 23.6% vs. 33.3%, p < 0.001), cardiac arrest (20% vs. 3.6% vs. 13.4%, p = 0.032), and undergo amputation (23.6% vs. 5.5% vs. 8.2%, p = 0.024). No significant differences were observed in long-term neurological deficits. Twenty-seven patients (16.7%) were found to have neurological deficits on or after admission; 48.2% recovered, 33.3% persisted, 7.4% died, and 11.1% did not follow-up with our burn center. Electrical injuries are associated with protean sequelae. Immediate complications include cardiac, renal, and deep burns. Neurologic complications, while uncommon, can occur immediately or are delayed.

Injuries Associated With Electrical Flash Burns in Children Caused by E-bike Batteries.

The use of electric bicycles (e-bikes) has increased in China. Alongside this increased use of e-bikes, reports of injuries related to e-bikes have also increased. However, few studies have explored electrical burns from short circuits in e-bike batteries, especially among children. Our study aimed to describe the epidemiology and prognosis of e-bike-related electrical flash burns in children. This retrospective analysis examined the injury patterns and prognosis of flash burn injuries from e-bike batteries among children presenting to the emergency department of a hospital in northern China from 2009 to 2020. Data collected included demographics, mechanism of injury, time of injury, injury site, burn depth, healing time, and patient prognosis. During the study period, 82 children presented to our emergency department with these injuries (boys: n = 64, 78%; girls: n = 18, 22%). The children's mean age was 3.5 (2.5) years. Burns occurred in all months of the year but peaked from May to August (spring and summer). Most burns were to the fingers. All burns were minor injuries that healed within 2 weeks with wound care. With the growing popularity of e-bikes, electric flash burns among children caused by e-bike batteries are increasingly common. Doctors should be aware of this special injury type to offer the correct diagnosis and treatment and provide parents with appropriate information.

We Got Your Back: Evaluating Recovery Following Spinal Cord Injury After High-Voltage Electric Burns.

Delayed spinal cord injury (SCI) is a relatively rare consequence of high voltage electrical burns, but it holds significant implications for patient quality of life. Due to the uncommon nature of delayed SCI and variable time of onset following injury, providers are currently unable to provide a prognosis for functional recovery and optimize a therapy process tailored to treat this patient populace. In this study, we aim to better map the pattern of recovery in these patients to better inform future rehabilitation practices. A retrospective chart review of five patients who experienced delayed SCI secondary to an electrical burn was conducted. The majority of patients displayed an upward trajectory in motor function following acute hospitalization and inpatient rehabilitation, with four of the five patients able to achieve complete motor strength in multiple extremities. In addition, rehabilitation was shown to have a noticeable impact in improving functional independence in tasks related to nursing. In conclusion, the clinical and functional outcomes of these delayed SCI patients point to the need for multidisciplinary management following injury and highlight the importance of early rehabilitation in regaining function.

[Analysis of the development trend of burn discipline from the literature published in Chinese Journal of Burns in 22 years].

Objective: To analyze the literature published in Chinese Journal of Burns (now Chinese Journal of Burns and Wounds) in the last 22 years, and to explore the development trend of burn discipline. Methods: The relevant clinical and research literature published in Chinese Journal of Burns from January 1, 2000 to December 31, 2021 were retrieved through China National Knowledge Infrastructure database. Bibliometrics was used to classify and analyze the literature by research types, involved research fields, and reported causes of injury, and compare them every 3 years according to the year of publication (with literature published in 2021 being included in the last time period). Keywords of all the literature were retrieved, which were corrected and conversed later. CiteSpace 6.1.R2 software was used to visually cluster the included keywords, count high-frequency and high-centrality keywords, and divide the high-frequency keywords by time as before for segment comparison. Results: A total of 4 485 relevant papers were included, with an average of about 204 papers each year. The research types analysis of literature showed that clinical diagnosis and treatment literature had the highest proportion, reaching 65.3% (2 929/4 485), followed by cell experiment and animal experiment literature, accounting for 18.1% (812/4 485) and 13.2% (591/4 485), respectively. The proportion of various research types of the literature in each time period was basically stable. The analysis of the research fields involved in the literature showed that the literature in the field of systemic treatment of burns accounted for the highest proportion, reaching 60.2% (2 699/4 485), followed by the literature in the fields of acute wounds and plastic surgery, accounting for 20.2% (908/4 485) and 7.3% (326/4 485), respectively. The proportion of the literature in the field of systemic treatment of burns decreased from 84.0% (430/512) in 2000-2002 to 40.3% (373/926) in 2018-2021, with a decreasing proportion of 43.7%. While compared with that in 2000-2002, the proportions of literature in the fields of acute wounds, plastic surgery, chronic wounds, and burn rehabilitation were on the rise, with the proportions in 2018-2021 increased by 11.7%, 9.1%, 10.7%, and 5.5%, respectively. In the first 6 time periods, the number of literature in the field of discipline management was few and remained in single digits, but it increased to 49 in 2018-2021. Among the 1 099 literature in the field of systemic treatment of burns with a clear cause of injury, the literature on thermal burns was the most, accounting for 58.5% (643/1 099), followed by the literature on electrical burns and chemical burns, accounting for 19.8% (218/1 099) and 12.6% (138/1 099), respectively. The comparison by time period showed that the proportion of literature reporting thermal burns showed a significant downward trend, while the proportion of literature reporting other causes of injury did not change significantly. A total of 6 822 keywords from 2 236 literature were included for analysis. Visual cluster analysis showed that relevant studies focused on burns, surgical flaps, scars, and wound healing. The top 3 keywords in frequency were burns, wound healing, and surgical flaps, and the top 3 keywords in centrality were burns, scars, and skin transplantation. The comparison by time period showed that the only keyword with a stable frequency in the top 10 ranks was burns; with the passage of time, some keywords such as endotoxin/endotoxins and fibroblasts gradually dropped out of the top 10 ranks, while keywords such as wounds and injuries, surgical flaps, and negative-pressure wound therapy gradually entered the top 10 ranks. Conclusions: Among the literature published in Chinese Journal of Burns during the last 22 years, the literature on systemic treatment of burns and thermal burns has gradually decreased, while the literature on chronic wounds and burn rehabilitation has increased. Surgical flaps, wound healing, and scar prevention and treatment are the current research hot spots in burn discipline.

Evaluation of Electrical Burn Injuries in Iran: A 7-Year Retrospective Study.

Electrical burn injuries can cause devastating and debilitating morbidities and impairments for patients. This cross-sectional descriptive study was performed on electrical burn patients hospitalized from 2014 to 2019 to evaluate electrical burn injuries' epidemiology and characteristics. A total number of 726 patients with the mean age of 31.17 years were evaluated for electrical burn injuries. Mean total burn surface area (TBSA) was 16.61 ± 12.56. Most victims were male (696 cases, 95.7%) and most patients did not have a constant job (n = 458, 63%). Most affected burn sites were hands (28.6%) and upper limbs (27.8%). A total number of 89 (12.2%) patients suffered amputations with the hand fingers (64 cases) as the most common site. Low-voltage injuries were more common (n = 649, 89%). Most incidents happened at the workplace (n = 459, 63%). Comparison of patients with high-voltage and low-voltage injuries showed significant correlations and statistical difference between these two groups regarding TBSA, mean hospital stays, escharectomy, fasciotomy, amputations, debridement, fracture, and mortality rate (P = .001). Our observation revealed that electrical burn injuries are still significant causes of morbidity and mortality among trauma patients. In contrast to previous studies, low-voltage injuries were more common than high-voltage ones. We propose improvements in the manufacturing of electrical appliances; paying attention to safety measures will reduce the number of incidents. Moreover, training and education play important roles in reducing the number of incidents and mortality rates.

Evaluation of the Epidemiological Characteristics of the Patients Admitted to Our Clinic as a Result of Electric Shock.

Electric shocks (ESs) are common traumas in burn units that require treatment by specialists due to high mortality and morbidity. This study aimed to investigate the demographic and clinical characteristics of patients of ES, complications, and injury-related mortality and morbidity rates. The authors retrospectively analyzed data of 432 ES patients treated at the Gazi Yasargil Training and Research Hospital Burn Center, Turkey, between January 2010 and December 2020. Of the 432 patients, 92 (21.3%) and 340 (78.7%) sustained high- and low-voltage injuries, respectively. While high-voltage burns were common in January and December, low-voltage burns peaked in September and July. Burn patients were mostly males and were between the ages of 19 and 59 years. The majority of the ES events occurred at home. All four patients who died had suffered high-voltage burns, with two of high-voltage burns (2.17%) requiring amputation. None of the patients with low-voltage burns underwent amputation. High-voltage injuries manifested with larger burn surfaces, longer hospitalization, and more complications. Electrical injuries are largely preventable with simple safety precautions in daily life as well as serious consideration of workplace safety.

Patterns and Outcomes of High-Voltage vs Low-Voltage Pediatric Electrical Injuries: An 8-Year Retrospective Analysis of a Tertiary-Level Burn Center.

Although electrical injuries (EIs) are rare traumas in the pediatric age group, they are considered one of the most devastating injuries. We aimed to evaluate the patterns and outcomes of pediatric high-voltage injuries (HVIs) vs low-voltage injuries (LVIs), admitted to the burn center within the efforts of determining evidence-based data for contributing to burn prevention strategies. A retrospective study was conducted on children with EIs hospitalized in the Burn Center of Adana City Training and Research Hospital for 8 years (2013-2020). Data including the patients' clinical and demographic characteristics, the percentage of total body surface area with burns (%TBSA), length of hospital stay, exposure place, electrical current type, and treatment results were collected and analyzed. EIs were detected in 57 (2.5%) of 2243 acute pediatric burn injury admissions. EIs were most frequently observed in the form of HVIs, among children within the age range of 13 to 18 years, mostly in residential outdoor environments, where the high-power lines still passing close to the home roofs and balconies, resulting from contact with them. Besides, to a lesser extent in LVIs, in the home environment among children younger than 5 years, which was caused by connection with substandard electrical cords/poor-quality electrical devices and inserting an object into the electric sockets. Concerning the mean of %TBSA, HVIs suffered more extensive burns than LVIs. The most frequently affected anatomical regions among HVIs and LVIs were the upper limb, followed by the lower limb. While superficial partial- and deep partial-thickness burns were significantly more common among the LVIs, full-thickness burns were more prevalent among the HVIs. The amputation rate was 12% of which only one of them was major amputation (forearm above the elbow joint). HVIs had more elevated creatine kinase (CK) and CK-myocardial band (CK-MB) levels than LVIs but were not correlated with electrocardiography findings. Only one death (caused by HVI) was observed, with a mortality rate of 1.8%. Pediatric EIs are less common than scald or fire flame-related burns in this age group but can cause significant morbidity and even mortality, especially in severe burns. It is possible to prevent possible morbidity and mortality by strengthening compliance with safety precautions, especially with parental education and raising social awareness. In this context, taking necessary precautions for passing high-voltage power lines under the ground, the standardization of electrical cables by the relevant legal regulations, the use of socket covers in homes, promoting the widespread use of residual current relays, and arrangements to be taken against the use of illegal electricity are among measures for the prevention strategy.

Therapeutic approach to electric burn with platelet rich plasma, grafts and hyperbaric oxygenation / Enfoque terapéutico de quemadura eléctrica con plasma rico en plaquetas, injertos y oxigenación hiperbárica

Abstract Contact electrical burns are more severe than other forms of contact burn injury. Moreover, treatment of hand burns is an important therapeutic challenge. We present a 17 year-old female of low voltage electric hand injury, admitted 5 days after injury. The patient was treated with autologous platelet rich plasma, porcine dermis heterograft and partial autologous skin graft, all of them with hyperbaric oxygen therapy (HBOT) at 1.45 ATA ≈100% O2 like adjuvant therapy. Good evolution and acceptable aesthetic results were reported. Although more studies are required, we suggest that multi-therapeutic approach could be effective in treatment for electric burns in hands.

Resumen Las quemaduras eléctricas por contacto son más graves que otras formas de quemaduras. Además, el tratamiento de las mismas en las manos es un importante desafío terapéutico. Presentamos el caso de una mujer de 17 años de edad con lesión en la mano por quemadura por electricidad de baja tensión. Fue ingresada 5 días después de la lesión y tratada con plasma rico en plaquetas autólogo, heteroinjerto de dermis porcina e injerto de piel autólogo parcial, todo con oxigenoterapia hiperbárica (TOHB) a 1.45 ATA ≈100% O2 como terapia adyuvante. Tuvo buena evolución y resultados estéticos aceptables. Aunque se requieren más estudios, sugerimos que el enfoque multi-terapéutico podría ser eficaz en el tratamiento de las quemaduras eléctricas en las manos.

Therapeutic approach to electric burn with platelet rich plasma, grafts and hyperbaric oxygenation.

Contact electrical burns are more severe than other forms of contact burn injury. Moreover, treatment of hand burns is an important therapeutic challenge. We present a 17 year-old female of low voltage electric hand injury, admitted 5 days after injury. The patient was treated with autologous platelet rich plasma, porcine dermis heterograft and partial autologous skin graft, all of them with hyperbaric oxygen therapy (HBOT) at 1.45 ATA "100% O2 like adjuvant therapy. Good evolution and acceptable aesthetic results were reported. Although more studies are required, we suggest that multi-therapeutic approach could be effective in treatment for electric burns in hands.

Las quemaduras eléctricas por contacto son más graves que otras formas de quemaduras. Además, el tratamiento de las mismas en las manos es un importante desafío terapéutico. Presentamos el caso de una mujer de 17 años de edad con lesión en la mano por quemadura por electricidad de baja tensión. Fue ingresada 5 días después de la lesión y tratada con plasma rico en plaquetas autólogo, heteroinjerto de dermis porcina e injerto de piel autólogo parcial, todo con oxigenoterapia hiperbárica (TOHB) a 1.45 ATA "100% O2 como terapia adyuvante. Tuvo buena evolución y resultados estéticos aceptables. Aunque se requieren más estudios, sugerimos que el enfoque multi-terapéutico podría ser eficaz en el tratamiento de las quemaduras eléctricas en las manos.

Institutional Experience Using a Treatment Algorithm for Electrical Injury.

Electrical injury has low incidence but is associated with high morbidity and mortality. Variability in diagnosis and management among clinicians can lead to unnecessary testing. This study examines the utility of an electrical injury treatment algorithm by comparing the incidence of testing done on a cohort of patients before and after implementation. Demographics, injury characteristics, and treatment information were collected for patients arriving to a regional burn center with the diagnosis of electrical injury from January 2013 to September 2018. Results were compared for patients admitted before and after the implementation of an electrical injury treatment algorithm in July 2015. There were 56 patients in the pre-algorithm cohort and 38 in the post-algorithm cohort who were of similar demographics. The proportion of creatine kinase (82% vs 47%, P < .0006), troponin (79% vs 34%, P < .0001), and urinary myoglobin (80% vs 45%, P < .0007) testing in the pre-algorithm cohort was significantly higher compared to post-algorithm cohort. There were more days of telemetry monitoring (median [IQR], 1 [1-5] vs 1 [1-1] days, P = .009) and greater ICU length of stays (4 [1-5] vs 1 [1-1] days, P = .009), prior to algorithm implementation. There were no significant differences in total hospital lengths of stay, incidence of ICU admissions, in-hospital mortality, or 30-day readmissions. This study demonstrates an electrical injury evaluation and treatment algorithm suggests a mode of triage to cardiac monitoring and hospital admission where necessary. Use of this algorithm allowed for reduction in testing and health care costs without increasing mortality or readmission rates.

Electrical Injuries in Children: A 10-Year Experience at a Tertiary Pediatric Burn Center.

Electrical injuries comprise 4% of cases but have higher morbidity and mortality. This study aims to share our experiences with pediatric electrical injuries and propose strategies to prevent them. The files of pediatric electrical injuries between 2010 and 2020 were reviewed retrospectively. The following were investigated: age, gender, cause, length of stay in the pediatric burn center, total burned surface area, voltage-type, and surgical procedures performed. The patients from low- and high-voltage groups were compared. Eighty-five patients were treated in the last 10 years. Seventy were males, the mean age was 9.9 years, the average length of stay in pediatric burn center was 18.2 days, and the average total burned surface area was 11.7%. Forty-three patients were injured with high-voltage and 42 with low-voltage electricity. Fasciotomy was performed in 25 patients, grafting in 40 patients, and amputation in 12 patients. The most often amputated limb was the right arm/forearm. Psychiatric disorders developed in 24 patients. One patient died. In conclusion, the incidence of high-voltage electrical injuries increases with age. They are more prevalent in males, more often accompanied by additional trauma, and have higher total burned surface area, surgical procedures are performed more often, and hospitalization times are longer. For prevention, precautions should be taken by governments and families, and education is critical.

Delayed Spinal Cord Injury From Electrical Burns: Two Cases.

Spinal cord injury has been described in only 2% to 5% of electrical injuries. When its presentation is delayed for several days to weeks after the initial injury, recovery is not the rule. Herein, we describe two patients who developed spinal cord injury from electrical burns. Case 1: A 60-year-old male presented with a 40% TBSA after contacting a power line. On hospital day 6, he developed lower extremity weakness that progressed to flaccid paralysis. Case 2: A 58-year-old male sustained a 9% TBSA high-voltage injury. On hospital day 2, he started to have progressive weakness of his lower extremities that progressed to flaccid paralysis. Neither case was judged to have experienced additional significant trauma. Neurological complications after electrical injuries are protean. Delayed spinal cord injury is rare and associated with variable degrees of recovery. Neurological follow-up with rehabilitation is essential for a successful recovery.