HIGH VOLTAGE ELECTRICAL INJURY TO UPPER LIMB: EARLY FASCIOTOMY IS PROCEDURE OF CHOICE IN LIMB SALVAGE

Nikita Gulab Rolekar* and Sunil Srivastava

ABSTRACT

Background: Electrical burns have the most catastrophic consequences of all burn injuries. High voltage electrical injuries of the extremities are at the risk of development of compartment syndrome during the first 48 h post injury. Damaged muscle and swelling within the investing fascia of the extremity may increase pressure to the point where muscle blood flow is compromised. Thus, the role and indication of an early fasciotomy for electrical burn injury was studied in this case series. Patients and methods: A retrospective analysis of 3 years from Jan 2016 to Dec 2018, 497 patients were admitted in our institute with high voltage electrical contact burn in upper limb. Out of 497patients, 350 had deep burn injury to upper limb and developed compartment syndrome, 147 patients had small patchy area of deep burn which were excluded. 322 (92%) were male and 28 (8%) were female, with age group from 8 yrs to 55yrs (mean age 36yrs). Early fasciotomy done in patient with upper limb deep electric burn with compartment syndrome. Result: Out of 497patients, 350 had deep burn injury to upper limb and developed compartment syndrome. All 350 patients were evaluated and early fasciotomy done. Out of 350 patients, we could salvage the limb in 298 (85%) patient and 52 (15%) patients had above or below elbow amputation. 212 Fasciotomy wound cover with skin graft and 86 patients had flap cover in salvage limb. Conclusion: Early fasciotomy in high voltage electrical burn in upper limb can salvage the limb and prevent amputation.

Keywords: Electric Burn, upper extremity, compartment syndrome, fasciotomy.