gms | German Medical Science

Objectives/Interrogation: Electrical burns of the upper limb are devastating injuries.

To date there are no specific classifications of electrical burns in the upper limb.

Due to the high number of electrical burn injuries treated in our institute we offer a classification and treatment algorithm for the immediate reanimation with tendon transfers after soft tissue cover in electrical burns of the upper limb.

Methods: Patient data was collected over one year and analysed with regards to sex distribution, high and low voltage burns, the areas of the upper limb affected, nerves, tendons and bones involved, amputation levels and soft tissue reconstructions including tendon transfers.

Results and Conclusions: Over 6000 burns are admitted to our institute each year. 27% are due to electrical injuries and 29% include the upper limb. Electrical burns cause 42% of the deaths in our burns patient population.

The vast majority of electrical burns are due to High Voltage electricity in males. 60% are admitted in the first 2 days post injury, but admissions continue up to 4 weeks post burn.

The most common place of injury was the workplace, followed by the home, roadside, educational institutes and the playground (Figure 1 [Fig. 1]).

The average Total Body Surface Area involved was 15% (range 1-50%): mostly 2nd and 4th degrees.

Nearly half necessitate amputations with nearly a third below elbow amputations.

20% include nerve injuries and include loss of tendons.

Surgical debridement was usually performed piecemeal and defects covered successfully with local flap. Tendons were buddied, transferred depending on availability and need.

On the basis of our data we offer an upper limb electrical burns classification, which facilitates surgical treatment and reconstruction.