Citation

Tapking C, Hundeshagen G, Popp D, Lee JO, Herndon DN, Zapata-Sirvent R, Branski LK. J. Burn Care Res. 2019; 40(1): 107-111.

Affiliation

Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria.

Copyright

(Copyright © 2019, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1093/jbcr/iry056

PMID

30371857

Abstract

Electrical injuries induce substantial morbidity and mortality. Amputations are often necessary to enable survival and based on tissue non-viability, development of life threatening infection or expected non-functional outcome. We analyzed occurrence and type of amputations in our institution for electrical and non-electrical pediatric burns and the number of reconstructive operations. Patients who underwent any amputation between 1999 and 2017 were identified. Patients with electrical burns (EB) were matched regarding age, sex and percent total body surface area (%TBSA) burned to patients with non-electrical burns (NEB). Both groups (n=35 EB, n=70 NEB) were comparable regarding age (EB,11.6±4.5 years;NEB,11.1±4.5 years,p=0.550) and %TBSA (36.7±15.4% and 37.7±12.9%,p=0.738). Major amputations (above wrist or ankle) were performed in 77% of EB vs. 31% of NEB (p<0.001). Amputations above knee or elbow were performed in 13 (37.1%) vs. two patients (2.9%,p<0.001). Eight (22.9%) vs. six patients (8.6%) underwent combination of two or more major amputations (p=0.042). In both groups, most amputations were performed for functional reasons. Length of stay was shorter in EB group (33±27 vs. 47±38 days,p=0.040). EB patients underwent 9.9±7.1 total operations compared to 14.4±5.1 operations (p<0.001). Of these, 6.5±3.6 and 7.9±3.3 (p=0.023) were performed during acute stay and 3.3±4.8 and 6.5±3.5 after acute stay (p<0.001), respectively. Mortality was comparable.Electrical burns were associated with larger extent of limb loss and more major amputations than non-electrical burns with amputations. They furthermore required a smaller number of reconstructive procedures. EB require extra attention of caregivers, because of their extensive tissue damage.

Language: en