Electrical burn injuries secondary to copper theft.

Abstract

overhead power lines (33,000 V). The risk of burns in this activity is significant, and may account for up to 10 % of electrical burns presenting to a regional unit [5]. We report three of these complex cases presenting between 2007 and 2011. All cases were males, aged 22, 25 and 42 years, sustaining burns of 32, 45 and 16.5 % total body surface area (TBSA), respectively. All patients survived, and there was a mean length of stay of 47 days (range 32–59) and all patients were involved in theft from 11,000 V electrical substations. Burns primarily affected the head, neck, trunk and upper limbs. In the patient with 16.5 % burns, the depth was all full-thickness, however, the other two cases had mixed depth burns. All patients required admission to intensive care, with a mean period of intubation of 8 days (range 2–18). The mean number of acute procedures was 7 (range 5–8), while two patients had immediate upper limb fasciotomies, one of which later required amputation. Multiple secondary procedures have been required, in particular to reconstruct hands and the head and neck (mean 2, range 1–4). Reconstruction has consisted of debridement, contracture releases and split-thickness skin grafts. One patient had an external fixator applied to the first web space following contracture release, having declined free flap reconstruction. Invariably, burns and related injuries occurring after copper theft from electrical substations carry substantial morbidity [6], and other studies have recognised an increase in case frequency [7]. Theft of copper may lead to electrical, flash or contact burns, and the patient may sustain blast effects with associated traumatic injuries. The cost of health care is considerable both acutely and longer-term, as rehabilitation and reconstruction may be life-long. Based on current data [8], the cost of acute bed days alone for these three patients combined was £147,000. The We welcome the paper by Duci et al. [1], highlighting the complexity and high mortality of electrical injuries, requiring management in a dedicated burns service. Of the high voltage injuries, two committed suicide and the remainder were accidental, with injuries in the workplace commonest. We would like to highlight copper theft as an international cause for high voltage electrical injury, with an illustration of cases over a 5-year period from the Yorkshire regional burns unit in the United Kingdom (UK). Prevention strategies are essential to reduce these devastating injuries. Copper price has risen dramatically in recent years, with a six-fold increase over the past decade and a large demand from booming economies such as China. Metal theft is one of the fastest rising crimes in the UK, [2] and during sharp price increases scrap copper may reach 90 % of the value of new copper [3]. Approximately 100 copper thefts per month occur in the UK, and the number correlates with a rise in price [4]. Sites with abundant copper are commonly sources of high voltage, such as electrical substations (11,000 V) and