Early surgical treatment of severe electrical injury of bilateral upper extremities: a case report

A patient with both upper limbs injured by high-voltage current was treated by early wound débridement, segmental excision of the necrosed humerus of the left upper arm, internal screw fixation and vascularized skin free grafting on the right wrist. Functional recovery were satisfactory.

Arterial injuries in electrically burned upper limbs and effects of early reconstruction of blood circulation to the wrist

Since May 1978, a new method using the saphenous vein as autograft for reconstruction of blood circulation to the wrist has been applied in treating a series of 14 cases of electrically burned upper limbs with vascular injuries of the wrist. Necrosis was averted in 10 upper limbs treated in this way. This paper reports the pathological findings in these 14 cases operated upon at an early stage as well as clinical observations on the injured arteries, arteriograms and operative findings. A pathological study was also made on the arteries of limbs amputated following conservative treatment. A pathological concept is suggested regarding the damage caused by an electrical current passing through the upper limb. This helps to explain the mechanism of electrical injuries and provides a pathological basis for early vascular reconstruction to prevent necrosis in electrical injuries of upper limbs.

Early vascular grafting to prevent upper extremity necrosis after electrical burns

Presented in this paper are the surgical considerations in the management of 8 electrically injured patients, with special reference to the care for wrist damage associated with impaired blood flow, and the prospect for effective recovery. Sound surgical principles, such as early diagnosis and repair of artery damage, complete débridement of dead tissue and affective wound closure, in conjunction with intensive general treatment and overall planning, are necessary for maximally rehabilitated limbs. The electrically injured seem to have benefited a great deal from the procedures outlined, with a lowered incidence of amputation and a better functional recovery.