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      Electrical Burn Injury: A Five-Year Survey of 682 Patients

      research-article
      1 , 1 , 1 , *
      Trauma Monthly
      Kowsar
      Electric Burns, Injury, Morbidity, Complications

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          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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          Most cited references18

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          Severe burn injury in europe: a systematic review of the incidence, etiology, morbidity, and mortality

          Introduction Burn injury is a serious pathology, potentially leading to severe morbidity and significant mortality, but it also has a considerable health-economic impact. The aim of this study was to describe the European hospitalized population with severe burn injury, including the incidence, etiology, risk factors, mortality, and causes of death. Methods The systematic literature search (1985 to 2009) involved PubMed, the Web of Science, and the search engine Google. The reference lists and the Science Citation Index were used for hand searching (snowballing). Only studies dealing with epidemiologic issues (for example, incidence and outcome) as their major topic, on hospitalized populations with severe burn injury (in secondary and tertiary care) in Europe were included. Language restrictions were set on English, French, and Dutch. Results The search led to 76 eligible studies, including more than 186,500 patients in total. The annual incidence of severe burns was 0.2 to 2.9/10,000 inhabitants with a decreasing trend in time. Almost 50% of patients were younger than 16 years, and ~60% were male patients. Flames, scalds, and contact burns were the most prevalent causes in the total population, but in children, scalds clearly dominated. Mortality was usually between 1.4% and 18% and is decreasing in time. Major risk factors for death were older age and a higher total percentage of burned surface area, as well as chronic diseases. (Multi) organ failure and sepsis were the most frequently reported causes of death. The main causes of early death (<48 hours) were burn shock and inhalation injury. Conclusions Despite the lack of a large-scale European registration of burn injury, more epidemiologic information is available about the hospitalized population with severe burn injury than is generally presumed. National and international registration systems nevertheless remain necessary to allow better targeting of prevention campaigns and further improvement of cost-effectiveness in total burn care.
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            A survey on 30 months electrical burns in Shiraz University of Medical Sciences Burn Hospital.

            Electrical burn is less common nowadays but still has complications and requires therapeutic interventions especially in developing countries. It occurs more in males and in industrial sites. The importance of electrical burn led us to study a 30 months history of electrical burn in Shiraz, Southern Iran. In a cross-sectional retrospective study, 1352 patients were surveyed for 30 months in relation to the cause, time, demographic information, therapeutic measures and prognosis of the electrical burn. Among burn patients, 4.73% were due to electrical burns (mean age, 30.5 years) and 95.3% were male. The mean hospitalization period was 11.5 days and the mean burn extent was 27.5%. Half of the victims were employees and 59.3% of the electrical burns occurred at their work site. 67.2% of burns were due to high voltage electrical current (more than 1000 V) and 4.6% of the patients died due to the direct cause of electrical burn. The high prevalence of electrical burn in males and workers emphasizes on the essence of standardization of occupational areas and use of trained workers to prevent electrical burns.
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              Does voltage predict return to work and neuropsychiatric sequelae following electrical burn injury?

              Voltage has historically guided the acute management and long-term prognosis of physical morbidity in electrical injury patients; however, few large studies exist that include neuropsychiatric morbidity in final outcome analysis. This review compares high (>1000 V) to low ( 1000 V), low voltage (<1000 V), flash arc, and lightning. Demographics, hospital course, and follow-up were recorded to determine physical and neuropsychiatric morbidity. Differences among cohorts were tested for statistical significance. Over 5 years, 2548 patients were admitted to the burn center, including 115 patients with electrical injuries. There were 110 males and 5 females, with a mean age of 35 years (range, 0.75-65 years). The cause of the electrical injury was high voltage in 60 cases, low voltage in 25 cases, flash arc in 29 cases and lightning in 1 case. The mean total body surface area burn was 8% (range, 0%-52%). The etiology was work-related electrical injury in 85 patients. Mean follow-up period was 352 days with 13 (11%) patients lost to follow-up. Patients with high voltage injuries had significantly larger total body surface area burn, longer ICU stays, longer hospitalizations, and significantly higher rates of fasciotomy, amputation, nerve decompression and outpatient reconstruction, with 4 cases of renal failure and 2 deaths. In spite of these differences, high and low voltage groups experienced similar rates of neuropsychiatric sequelae, limited return to work and delays in return to work. Final impairment ratings for the high and low voltage groups were 17.5% and 5.3%, respectively. Electrical injuries often incur severe morbidity despite relatively small burn size and/or low voltage. When comparing high and low voltage injuries, similarities in endpoints such as neuropsychiatric sequelae, the need for late reconstruction, and failure to return to work challenge previous notions that voltage predicts outcome.
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                Author and article information

                Journal
                Trauma Mon
                Trauma Mon
                10.5812/traumamon
                Kowsar
                Trauma Monthly
                Kowsar
                2251-7464
                2251-7472
                25 November 2014
                November 2014
                : 19
                : 4
                : e18748
                Affiliations
                [1 ]Burn Research Center, Department of Plastic and Reconstructive Surgery, Iran University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ]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: rezavaghardoost@ 123456gmail.com
                Article
                10.5812/traumamon.18748
                4310162
                25717451
                4c1482be-fcc2-4c63-bd00-20516e250db3
                Copyright © 2014, Kowsar; Published by Kowsar.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

                History
                : 06 March 2014
                : 26 April 2014
                Categories
                Research Article

                electric burns,injury,morbidity,complications
                electric burns, injury, morbidity, complications

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