J.Jpn. Surg. Soc.. 99(1): 52-56, 1998

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Feature topic

ELECTRICAL INJURY

Electrical injury can be classified into true electrical injury, arc burn, and flame burn. In true electrical injury, large or small, dry, dark brown necrotic wounds (electric current spots) are observed on the skin at the entrance and exit sites of the electric current, and progressive necrosis develops in surrounding tissues. As generalized symptoms, ventricular fibrillation, respiratory arrest, and loss of consciousness may be observed temporarily immediately after the injury. Necrosis also occurs in deep tissues including muscles, and pathology resembling crush injury is seen. Myoglobin released into the circulation due to muscle necrosis tissue causes myoglobinuria and increases the risk of acute renal failure.
Treatment consists of emergency resuscitation and fiuid supplementation with lactated Ringer’s solution. However, more fluid should be administered than in cases of common burns to accelerate urinary excretion of myoglobin in the circulation.
For local treatment, debridement should be performed in aeras with clear third-degree burns, but in the presence of progressive necrosis, repair and reconstruction after debridement should be postponed for 2～3 weeks.

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