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Navarrete N, Rodriguez-Parra JD. Letter to the Editor regarding "Predictors of mortality following electrical and lightning injuries in Malawi: A decade of experience". Burns 2024:S0305-4179(24)00186-4. [PMID: 38987081 DOI: 10.1016/j.burns.2024.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 06/08/2024] [Indexed: 07/12/2024]
Affiliation(s)
- Norberto Navarrete
- Emergency Physician, Clinical Epidemiology, Burn Intensive Care Unit, Simón Bolívar Hospital, Bogotá, Colombia.
| | - Juan David Rodriguez-Parra
- Department of Burns and plastic surgery, Clinical Epidemiology, Simón Bolívar Hospital, Bogotá, Colombia.
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Choong E, Jurat D, Sandeep B, Rainnie B, Manzanero S, Dowsey M, McPhail S, Choong PF, Wood F. The impact of infection on length of stay in adult burns: A scoping review. Burns 2024; 50:797-807. [PMID: 38307765 DOI: 10.1016/j.burns.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 11/29/2023] [Accepted: 01/10/2024] [Indexed: 02/04/2024]
Abstract
BACKGROUND The disruption to the immune system and profound metabolic response to burn injury gives rise to a unique susceptibility to infection. Indeed, infection is one of the most frequently encountered post-burns complications placing significant burden on patients and healthcare system. Advancements in burn care have led to marked improvements in burn-related mortality and morbidity; however, scarce hospital resources hamper adequate burn-related care, and patient length of stay (LOS) in hospital is an important drain on such resources. The aim of this review was to assess and evaluate the existing literature relating to the impact of infections on LOS in hospitalised, adult burn patients. METHODS Electronic searches were performed in Medline and Embase. Eligible studies were those reporting on LOS and infection in adult burn populations. Articles published before 2000 were excluded to ensure that the analysis was focused on contemporary literature that reflects current, clinical management of burn patients. RESULTS Nineteen studies (54,397 burn patients) were included in the review. All studies were retrospective, with the majority undertaken in North America (14 studies). The mean age range was 38-67 years and the majority of patients were male. Inhalation injury was recorded in eleven studies. The most common types of infection included pneumonia, blood stream infections (BSI) and burn wound infections. Overall, there was a trend towards a positive association between infection and LOS. CONCLUSION The results of this scoping review provide an overview of the existing literature on the relationship between infection and LOS in adult burn populations. However, significant gaps remain in knowledge which call for further high-quality research. Standardised definitions for the collection of infection data and the use of burns specific infection control guidelines are also critical to understanding and improving patient outcomes.
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Affiliation(s)
- Emma Choong
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; St Vincent's Hospital Melbourne, Fitzroy 3065, Victoria, Australia; University of Melbourne, Department of Surgery, St. Vincent's Hospital Melbourne, Victoria, Australia.
| | - Danika Jurat
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; State Burns Unit, Fiona Stanley Hospital, Murdoch 6150, Western Australia, Australia
| | - B Sandeep
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; State Burns Unit, Fiona Stanley Hospital, Murdoch 6150, Western Australia, Australia
| | - Briana Rainnie
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; Royal Brisbane and Women's Hospital, Herston 4029, Queensland, Australia
| | - Silvia Manzanero
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; Jamieson Trauma Institute, Metro North Health, Butterfield Street, Herston, Brisbane, QLD 4029, Australia; School of Clinical Sciences, Queensland University of Technology, Brisbane, QLD 4059, Australia
| | - Michelle Dowsey
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; University of Melbourne, Department of Surgery, St. Vincent's Hospital Melbourne, Victoria, Australia
| | - Steven McPhail
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove 4059, Queensland, Australia; Digital Health and Informatics Directorate, Metro South Health, Woolloongabba 4102, Queensland, Australia
| | - Peter Fm Choong
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; University of Melbourne, Department of Surgery, St. Vincent's Hospital Melbourne, Victoria, Australia
| | - Fiona Wood
- Infection Collaboration in trAuma, orthopaedics and burns (ICARAUS), Australia; State Burns Unit, Fiona Stanley Hospital, Murdoch 6150, Western Australia, Australia
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Peters J, Bello MS, Spera L, Gillenwater TJ, Yenikomshian HA. The Impact of Race/Ethnicity on the Outcomes of Burn Patients: A Systematic Review of the Literature. J Burn Care Res 2022; 43:323-335. [PMID: 34520543 DOI: 10.1093/jbcr/irab174] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Racial and ethnic disparities are endemic to the United States and are only beginning to attract the attention of researchers. With an increasingly diverse population, focused and tailored medicine to provide more equitable care is needed. For surgical trauma populations, this topic is a small but expanding field and still rarely mentioned in burn medicine. Disparities in prevention, treatment, and recovery outcomes between different racial and ethnic minorities who are burned are rarely discussed. The purpose of this study is to determine the current status of identified disparities of care in the burn population literature and areas of future research. A systematic review was conducted of literature utilizing PubMed for articles published between 2000 and 2020. Searches were used to identify articles that crossed the burn term (burn patient OR burn recovery OR burn survivor OR burn care) and a race/ethnicity and insurance status-related term (race/ethnicity OR African-American OR Black OR Asian OR Hispanic OR Latino OR Native American OR Indigenous OR Mixed race OR 2 or more races OR socioeconomic status OR insurance status). Inclusion criteria were English studies in the United States that discussed disparities in burn injury outcomes or risk factors associated with race/ethnicity. One thousand one hundred and sixty-nine papers were populated, 55 were reviewed, and 36 articles met inclusion criteria. Most studies showed minorities had poorer inpatient and outpatient outcomes. While this is a concerning trend, there is a paucity of literature in this field and more research is needed to create culturally tailored medical care and address the needs of disadvantaged burn survivors.
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Affiliation(s)
- Jasmine Peters
- Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Mariel S Bello
- LAC+USC Hospital, University of Southern California, Los Angeles, USA
- Department of Psychology, University of Southern California, Los Angeles, USA
| | - Leigh Spera
- LAC+USC Hospital, University of Southern California, Los Angeles, USA
| | - T Justin Gillenwater
- Division of Plastic Surgery, University of Southern California, Los Angeles, USA
| | - Haig A Yenikomshian
- Division of Plastic Surgery, University of Southern California, Los Angeles, USA
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4
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López-Jácome LE, Chávez-Heres T, Becerra-Lobato N, García-Hernández MDL, Vanegas-Rodríguez ES, Colin-Castro CA, Hernández-Durán M, Cruz-Arenas E, Cerón-González G, Cervantes-Hernández MI, Ortega-Peña S, Mondragón-Eguiluz JA, Franco-Cendejas R. Microbiology and Infection Profile of Electric Burned Patients in a Referral Burn Hospital in Mexico City. J Burn Care Res 2021; 41:390-397. [PMID: 31711214 DOI: 10.1093/jbcr/irz177] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Electrical burn injuries are one of the most severe forms of trauma. This study aims to investigate the infection complications in electrical burn patients in a referral hospital in Mexico City. A longitudinal retrospective study was conducted, involving electrical burn patients admitted from April 2011 to December 2016. Demographic and clinical data including type of electric burns, infection complications, and mortality was sought. Data were collected at admission and daily until discharge. Number and type of infections and microorganism isolations were sought. Risk factors for death were analyzed. A total of 111 patients were included, of which 96.4% were males, mean age of 31.6±16.22, most injuries were high voltage associated. The total body surface area average was 27.8% ± 19.63. The overall infection rate was 72.9 cases per 100 patients. Mortality was observed in 4 (3.6%) patients. About 59.1% (443/749) had growth for Gram-negative bacteria. Multidrug-resistant Pseudomonas aeruginosa was the most frequent microorganism isolated. Fungi were present in 4.9% of cases. Electrical burn injuries occurred in young males in our study. Infection was frequent, most of them caused by Gram-negative rods with an important rate of antimicrobial resistance; however, an important microbial diversity was present.
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Affiliation(s)
- Luis Esaú López-Jácome
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Tatiana Chávez-Heres
- Unit of Hospital Epidemiology Surveillance, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Noé Becerra-Lobato
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - María de Lourdes García-Hernández
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Edgar Samuel Vanegas-Rodríguez
- Unit of Hospital Epidemiology Surveillance, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Claudia Adriana Colin-Castro
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Melissa Hernández-Durán
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Esteban Cruz-Arenas
- Unit of Hospital Epidemiology Surveillance, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Guillermo Cerón-González
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Mercedes Isabel Cervantes-Hernández
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Silvestre Ortega-Peña
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Jaime Arturo Mondragón-Eguiluz
- Unit of Hospital Epidemiology Surveillance, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
| | - Rafael Franco-Cendejas
- Infectious Diseases Division, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Av. México-Xochimilico #289 Col, Arenal de Guadalupe, Alc. Tlalpan, Mexico City, Mexico
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5
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Nisar S, Keyloun JW, Kolachana S, McLawhorn MM, Moffatt LT, Travis TE, Shupp JW, Johnson LS. Institutional Experience Using a Treatment Algorithm for Electrical Injury. J Burn Care Res 2021; 42:351-356. [PMID: 33530107 DOI: 10.1093/jbcr/irab020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
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.
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Affiliation(s)
- Saira Nisar
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,The Burn Center, MedStar Washington Hospital Center, District of Columbia, USA
| | - John W Keyloun
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,The Burn Center, MedStar Washington Hospital Center, District of Columbia, USA
| | - Sindhura Kolachana
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Melissa M McLawhorn
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA
| | - Lauren T Moffatt
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,Department of Biochemistry and Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Taryn E Travis
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Jeffrey W Shupp
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,The Burn Center, MedStar Washington Hospital Center, District of Columbia, USA.,Department of Biochemistry and Molecular and Cellular Biology, Georgetown University School of Medicine, Washington, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA
| | - Laura S Johnson
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia, USA.,The Burn Center, MedStar Washington Hospital Center, District of Columbia, USA.,Department of Surgery, Georgetown University School of Medicine, Washington, District of Columbia, USA
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6
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Keyloun JW, Travis TE, Johnson LS, Shupp JW. An unusual presentation of inhalation injury in a patient with high voltage electrical injury: A case report. Int J Surg Case Rep 2020; 77:357-361. [PMID: 33217653 PMCID: PMC7683282 DOI: 10.1016/j.ijscr.2020.10.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/28/2020] [Accepted: 10/29/2020] [Indexed: 11/26/2022] Open
Abstract
Electrical injury is associated with significant morbidity and mortality. Foreign body aspiration complicates the diagnosis of inhalation injury. Specialized burn care is required in cases of complex high-voltage electrical injury.
Background Electrical injuries comprise a minority of burn center admissions but are associated with significant morbidity and mortality. This is a case of a patient who suffered high-voltage electrical injury who survived despite developing several sequalae, who had an unusual presentation of inhalation injury complicated by the aspiration of metal screws. Case presentation This is a 20-year-old male who suffered electrical contact injury, and 45.5% total body surface area (TBSA) burns from electrothermal discharge and subsequent ignition of clothing, whose hospital course was complicated by rhabdomyolysis, compartment syndrome, renal failure, and inhalation injury. After cardiac arrest with successful defibrillation and intubation in the field, he was found to have metallic foreign bodies in his airway. Metal screws were retrieved using rigid bronchoscopy and lower extremity escharotomy was performed for compartment syndrome. He was placed on renal replacement therapy for persistent acidosis and severe rhabdomyolysis. On post-burn day (PBD) 3 he developed severe hypoxia and bronchoscopy showed evidence of inhalation injury. This was treated with protocolized nebulizer treatments, prone-positioning, early tracheostomy, and frequent bronchoscopy. Over his hospital course he required lower extremity amputation and numerous excision and grafting procedures. Ultimately, he exhibited renal and respiratory recovery. He was discharged on PBD 75 to a rehabilitation hospital. Conclusions This case highlights that electrical injuries are associated with serious sequelae that can be overt or occult. Clinicians must maintain a high index of suspicion for comorbid conditions with electrically injured patients given variable presentations and the need for prompt, aggressive, and complex management.
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Affiliation(s)
- John W Keyloun
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Taryn E Travis
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Laura S Johnson
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Department of Surgery, Georgetown University School of Medicine, Washington, DC, USA
| | - Jeffrey W Shupp
- Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, DC, USA; The Burn Center, MedStar Washington Hospital Center, Washington, DC, USA; Departments of Surgery and Biochemistry, Georgetown University School of Medicine, Washington, DC, USA.
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7
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Nosanov LB, Romanowski KS. Firefighter Postinjury Return to Work: A Balance of Dedication and Obligation. J Burn Care Res 2020; 41:935-944. [PMID: 32441739 DOI: 10.1093/jbcr/iraa079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Firefighters are at significant risk for burn injuries. Most are minor and do not significantly affect ability to work in full capacity, but there exists risk for both short- and long-term incapacitation. Many push for earlier return to work than is medically advisable. An online cross-sectional survey was sent to a statewide Professional Firefighters' Union. Multiple-choice format was used to assess demographics, injury details, medical care received, and return to work, with free-text format for elaboration. The survey was sent to 30,000 firefighters, with 413 (1.4%) responses. After exclusions, 354 remained for analysis with 132 burn-injured. Burns were small and affected the head (45.5%) and upper extremities (43.2%). Reported gear use was 90.7%, and the majority were not treated at a Burn Center. While 12 (12.1%) returned prematurely, nearly half knew a colleague who they felt had returned too soon. Factors cited include firefighter culture, finances, pressure from peers and employers, dislike of light duty, and a driving desire to get back to work. While many cite love of the job and a culture of pride and camaraderie that is "in our DNA," firefighters' decisions to return to work after burn injury are equally driven external pressures and obligations. Additional education is needed, which may best be facilitated by treatment at a Burn Center. Improved understanding of factors driving firefighters' views on returning to duty after injury may help establish support systems and improve education regarding risks of premature return to work, particularly with regard to reinjury.
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Affiliation(s)
- Lauren B Nosanov
- Department of General Surgery, MedStar Georgetown University Hospital-Washington Hospital Center, Washington, District of Columbia
| | - Kathleen S Romanowski
- Department of Surgery, Division of Burn Surgery, University of California-Davis, Sacramento
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Shih JG, Shahrokhi S, Jeschke MG. Review of Adult Electrical Burn Injury Outcomes Worldwide: An Analysis of Low-Voltage vs High-Voltage Electrical Injury. J Burn Care Res 2018; 38:e293-e298. [PMID: 27359191 PMCID: PMC5179293 DOI: 10.1097/bcr.0000000000000373] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The aims of this article are to review low-voltage vs high-voltage electrical burn complications in adults and to identify novel areas that are not recognized to improve outcomes. An extensive literature search on electrical burn injuries was performed using OVID MEDLINE, PubMed, and EMBASE databases from 1946 to 2015. Studies relating to outcomes of electrical injury in the adult population (≥18 years of age) were included in the study. Forty-one single-institution publications with a total of 5485 electrical injury patients were identified and included in the present study. Fourty-four percent of these patients were low-voltage injuries (LVIs), 38.3% high-voltage injuries (HVIs), and 43.7% with voltage not otherwise specified. Forty-four percentage of studies did not characterize outcomes according to LHIs vs HVIs. Reported outcomes include surgical, medical, posttraumatic, and others (long-term/psychological/rehabilitative), all of which report greater incidence rates in HVI than in LVI. Only two studies report on psychological outcomes such as posttraumatic stress disorder. Mortality rates from electrical injuries are 2.6% in LVI, 5.2% in HVI, and 3.7% in not otherwise specified. Coroner's reports revealed a ratio of 2.4:1 for deaths caused by LVI compared with HVI. HVIs lead to greater morbidity and mortality than LVIs. However, the results of the coroner's reports suggest that immediate mortality from LVI may be underestimated. Furthermore, on the basis of this analysis, we conclude that the majority of studies report electrical injury outcomes; however, the majority of them do not analyze complications by low vs high voltage and often lack long-term psychological and rehabilitation outcomes after electrical injury indicating that a variety of central aspects are not being evaluated or assessed.
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Affiliation(s)
- Jessica G Shih
- From the *Division of Plastic Surgery, Department of Surgery and †Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; ‡Department of Immunology, University of Toronto, Ontario, Canada; and §Sunnybrook Research Institute, Toronto, Ontario, Canada
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Hsieh CH, Sudario-Lumague R, Yang JS, Lin CC, Hsu SY. Analysis of electrical injury in a Level I southern Taiwan trauma center. FORMOSAN JOURNAL OF SURGERY 2018. [DOI: 10.4103/fjs.fjs_60_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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10
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Li H, Tan J, Zhou J, Yuan Z, Zhang J, Peng Y, Wu J, Luo G. Wound management and outcome of 595 electrical burns in a major burn center. J Surg Res 2017. [DOI: 10.1016/j.jss.2017.02.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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11
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Ghavami Y, Mobayen MR, Vaghardoost R. Electrical burn injury: a five-year survey of 682 patients. Trauma Mon 2014; 19:e18748. [PMID: 25717451 PMCID: PMC4310162 DOI: 10.5812/traumamon.18748] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Accepted: 04/26/2014] [Indexed: 12/29/2022] Open
Abstract
Background: Electrical burn is less prevalent in comparison to other forms of burn injuries, however this type of injury is considered as one of the most devastating due to high morbidity and mortality. Understanding the epidemiologic pattern of electrical burns helps determine the contributing factors leading to this type of injury. Objectives: Epidemiologic studies on electrical burn are scarce in Iran. This study was conducted to evaluate electrical burn injury at our center. Materials and Methods: Demographic data, etiology, burn percentage and other measures related to electrical burn injury of 682 electrical burn patients treated from 2007 to 2011 were collected and analyzed. Results: We assessed 682 electrical burn patients (~10.8% of all burn patients); the mean age was 29.4 years and 97.8% were males. The mean hospital stay was 18.5 days and the mean burn extent was 14.43%. Severe morbidities caused 17 (2.5%) deaths. Amputation was performed in 162 cases. The most common amputation site was the fingers (35%). Most victims were workers and employees and 68.5% of electrical burns occurred at their workplace; 72% of electrical burns were due to high voltage electrical current (more than 1000 V). There was a correlation between voltage and amputation (P = 0.001) and also between voltage and fasciotomy (P = 0.033), but there was no correlation between voltage and mortality (P = 0.131) Conclusions: Electrical burn injuries are still amongst the highest accident-related morbidities and mortalities. Educating the population about the dangers and hazards associated with improper use of electrical devices and instruments is imperative.
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Affiliation(s)
- Yaser Ghavami
- Burn Research Center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, IR Iran
| | - Mohammad Reza Mobayen
- Burn Research Center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, IR Iran
| | - Reza Vaghardoost
- Burn Research Center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Reza Vaghardoost, Burn Research Center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, IR Iran. Tel: +98-2188770031, Fax: +98-2188770048, E-mail:
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12
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Regional Neurovascular Inflammation and Apoptosis Are Detected After Electrical Contact Injury. J Burn Care Res 2014; 35:11-20. [DOI: 10.1097/bcr.0b013e3182a2accd] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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