Prevention and treatment of electrical burn injury: much progresses achieved yet further efforts still needed

Abstract

Electrical burn injury is very common, including electrical contact burn, electrical arc burn, and lightning burn, etc. Electrical burn patients account for 0.04 to 5 percent of all burn victims in the developed countries, while it hit up to 27 percent in the developing countries, much more than the global average of 4.5 percent. Historical and recent data have shown that the electrical burn injuries in China, either for the case number, the proportion of burn patients in hospital, or the population incidence per year, are much higher than those of the developed countries and the global average. Before the 1960s, conservative treatment or skin grafts after repeated debridements were used for electrical burns, resulting in high rates of amputation and severe deformity. In the 1960s, transplantation of flaps after debridement in early stage were used for repairing wrist electrical burn wounds, breaking through the traditional conservative methods. In the 1980s, local, distant and island pedicled skin or myocutaneous flaps were widely used for early stage repair of electrical burn wounds. In recent years, along with the increasing experience of evaluating the blood vessel injuries and the development of microsurgical techniques, free flaps have been more and more used to cover the deep wounds of electrical burns in early stage, leading to much better effects and shorter length of hospital stay. With the persistent efforts of the burn specialists in the last decades, great improvements have been made for the treatment of electrical burn injuries in China. Future study on decoding the full mechanism of electrical burn injury, exploring new methods to save the injured but not yet necrotic tissue, are still needed to improve the treatment and reduce amputation and deformity of electrical burn injury.