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Early coverage of upper extremity electrical injury wounds.

Nazerani S, Sohrabi M, Shirali A, Nazerani T - Trauma Mon (2012)

Bottom Line: In the present study we report our experience with early coverage of electrically injured upper extremity vital structures with encouraging results.Mean days of return to work was 132.57 (SD = 64.99).Early coverage of partially injured vital structures is gaining acceptance and this paper confirms the above mentioned treatment protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Firouzgar Hospital, Tehran, IR Iran, Tehran, IR Iran.

ABSTRACT

Background: An appropriate and well-timed surgery has great impact on a patient's treatment and can prevent further damage to partially injured structures which if untreated will be lost leading to severe disability. In the present study we report our experience with early coverage of electrically injured upper extremity vital structures with encouraging results.

Objectives: The aim of this study was to evaluate the results of early flap coverage (less than two weeks) after electrical injury in the induced wounds of upper extremity.

Materials and methods: The records of electrically injured patients referred during a 10- year period to Firuzgar Medical Center were evaluated. After one or two sessions of debridement, the wounds were covered by distant or pedicled flaps and the results were evaluated according to the number of surgeries, complications and return to work time.

Results: Thirty patients were registered in this study, mean age at the time of injury was 26.43 (SD = 10.41) years; 40% of patients had right upper extremity injury, 23.3% had left and 36.7% had bilateral injury. 43.4% of patients had no complications, amputation rate was 23.3% and nerve injury was seen in 13.3% of patients. Mean days of return to work was 132.57 (SD = 64.99). In 11 patients distant flaps were used, 9 patients with graft only and 7 patients had a combination of graft and regional flaps.The dominant hand involvement in electrical injury is very high.

Conclusions: We suggest that the routine treatment protocols of serial debridement until all the wound acquires a bed of granulation tissue should be revised, because the vital structures such as tendons and nerves will have undergone dessication necrosis and a young worker will be crippled for life. Early coverage of partially injured vital structures is gaining acceptance and this paper confirms the above mentioned treatment protocol.

No MeSH data available.


Related in: MedlinePlus

A Construction Worker with Electrical Burn During Work. A) Tendons Were Exposed and Frame Were Used to Fix the Hand. B) Rectus Muscle with Arteries is Ready to Transfer. C) After 6 Days Muscle is Ready to Graft D) Graft is Done and the Skin is Clean. E) Exit Site F) Donor Site
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fig347: A Construction Worker with Electrical Burn During Work. A) Tendons Were Exposed and Frame Were Used to Fix the Hand. B) Rectus Muscle with Arteries is Ready to Transfer. C) After 6 Days Muscle is Ready to Graft D) Graft is Done and the Skin is Clean. E) Exit Site F) Donor Site

Mentions: Distant and free flaps were used in 11 patients (36.7%), in 9 patients (30%) skin graft and in 7 patients (23.3%) a combination of skin graft and flaps was used. Time to return to work in flaps was 106.45 (SD = 71.06), in the combination of flap and graft was154.14 (SD = 67.28) and in the other cases (SD = 6.36) 115.50 days. The flaps that were mostly used included 45% of abdominal flaps, followed by 30% reverse forearm flap, 20% free muscle flap, and 5% musculocutaneus flap. One case presented in Figure 2 who was a construction worker with electrical burn during work which was referred after 4 days. He had a clean wound however tendons and nerves had dessication necrosis.


Early coverage of upper extremity electrical injury wounds.

Nazerani S, Sohrabi M, Shirali A, Nazerani T - Trauma Mon (2012)

A Construction Worker with Electrical Burn During Work. A) Tendons Were Exposed and Frame Were Used to Fix the Hand. B) Rectus Muscle with Arteries is Ready to Transfer. C) After 6 Days Muscle is Ready to Graft D) Graft is Done and the Skin is Clean. E) Exit Site F) Donor Site
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3860623&req=5

fig347: A Construction Worker with Electrical Burn During Work. A) Tendons Were Exposed and Frame Were Used to Fix the Hand. B) Rectus Muscle with Arteries is Ready to Transfer. C) After 6 Days Muscle is Ready to Graft D) Graft is Done and the Skin is Clean. E) Exit Site F) Donor Site
Mentions: Distant and free flaps were used in 11 patients (36.7%), in 9 patients (30%) skin graft and in 7 patients (23.3%) a combination of skin graft and flaps was used. Time to return to work in flaps was 106.45 (SD = 71.06), in the combination of flap and graft was154.14 (SD = 67.28) and in the other cases (SD = 6.36) 115.50 days. The flaps that were mostly used included 45% of abdominal flaps, followed by 30% reverse forearm flap, 20% free muscle flap, and 5% musculocutaneus flap. One case presented in Figure 2 who was a construction worker with electrical burn during work which was referred after 4 days. He had a clean wound however tendons and nerves had dessication necrosis.

Bottom Line: In the present study we report our experience with early coverage of electrically injured upper extremity vital structures with encouraging results.Mean days of return to work was 132.57 (SD = 64.99).Early coverage of partially injured vital structures is gaining acceptance and this paper confirms the above mentioned treatment protocol.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Firouzgar Hospital, Tehran, IR Iran, Tehran, IR Iran.

ABSTRACT

Background: An appropriate and well-timed surgery has great impact on a patient's treatment and can prevent further damage to partially injured structures which if untreated will be lost leading to severe disability. In the present study we report our experience with early coverage of electrically injured upper extremity vital structures with encouraging results.

Objectives: The aim of this study was to evaluate the results of early flap coverage (less than two weeks) after electrical injury in the induced wounds of upper extremity.

Materials and methods: The records of electrically injured patients referred during a 10- year period to Firuzgar Medical Center were evaluated. After one or two sessions of debridement, the wounds were covered by distant or pedicled flaps and the results were evaluated according to the number of surgeries, complications and return to work time.

Results: Thirty patients were registered in this study, mean age at the time of injury was 26.43 (SD = 10.41) years; 40% of patients had right upper extremity injury, 23.3% had left and 36.7% had bilateral injury. 43.4% of patients had no complications, amputation rate was 23.3% and nerve injury was seen in 13.3% of patients. Mean days of return to work was 132.57 (SD = 64.99). In 11 patients distant flaps were used, 9 patients with graft only and 7 patients had a combination of graft and regional flaps.The dominant hand involvement in electrical injury is very high.

Conclusions: We suggest that the routine treatment protocols of serial debridement until all the wound acquires a bed of granulation tissue should be revised, because the vital structures such as tendons and nerves will have undergone dessication necrosis and a young worker will be crippled for life. Early coverage of partially injured vital structures is gaining acceptance and this paper confirms the above mentioned treatment protocol.

No MeSH data available.


Related in: MedlinePlus