The contemporary management of electrical injuries: Resuscitation, reconstruction, rehabilitation

PURPOSE: Due to advances in resuscitation of patients with electrical injuries, new challenges in reconstruction and rehabilitation have emerged. This study is a comprehensive institutional review of a prospectively gathered database of patients with electrical injuries, from initial resuscitation through final impairment ratings. METHODS: A trauma registry was used to identify patients with electrical injuries. Procedures needed, their timing, final impairment ratings, and return to work were recorded. RESULTS: From 2000 through 2005, we managed 115 patients with electrical injuries. Mean follow-up was 352 days. The average patient age was 34.9 years. Eighty-five (73.9%) of these injuries were work-related. There were 2 mortalities (1.7%). Although average burn size was only 8%, patients suffered many complications acutely and chronically. Numerous surgical interventions were required during the resuscitative (within 48 hours), an early reconstructive and resurfacing (within 30 days), and a late reconstructive and rehabilitative phase. Mean final impairment rating was 11%. Average time to return to work was 101 days. CONCLUSIONS: Electrical injuries can produce significant morbidity despite relatively small burn sizes. Patients require early operative procedures for prevention of further injury. Timely reconstructive surgery may improve final function and return to productivity. Finally, continued reconstruction may ensure improved late outcomes. The plastic surgeon is essential to patients with electrical injuries through all phases of their care.