High-voltage Electrical Burns Research Articles

Monocular Electrical Cataract: A Case Report

Introduction : An electric shock is experienced when an electric current passes through a part of the body from an entry point to an exit point. Cataract is frequently described as a complication of electrical injury and it is usually bilateral. We report a rare case of high voltage electric injury in young male patient resulting in monocular cataract.
 Case Illustration : A 23 years old man was presented with a diminution of vision one year after sustaining an overhead high voltage power transmission wire that stung his head. The visual acuity of the right eye was hand movement dan 1.0 in the left eye. On slit-lamp examination, opacities were presented in the lens of the right eye and a clear lens in the left eye. Being diagnosed as having monocular cataract, the patient was then performed phacoemulsification on his right eye (April 12th 2023). The pupil shrank until 5 mm during the surgery but foldable IOL was successfully inserted in the capsule. The right eye vision was improved to 0.5 one day after surgery.
 Discussion : The consequences of high-voltage electric burns are complex. Electrical shock can cause protein coagulation and cataract formation. Lens manifestations are more likely when the transmission of current involves the patient’s head. Proper management of electrical cataracts will result in good visual rehabilitation if the eye does not suffer additional damage as in this case.
 Conclusion : Secondary cataract formation due to electric injury may occur, therefore routine examinations with the ophthalmologist are needed after the electrical trauma. The incidence of monocular cataracts after the electric injury is rare.

Skin Care Experience of a Case of Multiple Organ Failure Caused by High-Voltage Electrical Injury

Background: High-voltage electrical burns are caused by the direct transmission of electric current through the body and the conversion of electric energy into heat energy, which directly heats the tissues and leads to organ function damage. Especially after high-voltage electric burns (more than 1000W), it can not only cause coagulation necrosis of the skin and even carbonization, but also cause serious deep tissue damage .The degree of tissue damage depends on the type of current, the magnitude of current, the frequency, the voltage, the resistance of the tissue, the skin humidity, the duration, the contact area, and other factors. Low voltage and low frequency electric shock mainly affect the heart and respiration, which can lead to insignificant soft tissue damage. High voltage electric shock mainly causes serious soft tissue damage, which can be accompanied by changes in the circulatory system and respiratory system.[1] Subject and Method: We collected the data of a case of multiple organ failure caused by high-voltage electricity that was successfully treated in July 2023.In the course of this patient's successful treatment, The main nursing measures were analyzed: The intake and output volume were actively controlled. Albumin supplementation, Debridement and dressing change were performed daily, Covered with nano-silver ion dressing, Try to ensure a sterile environment during operation, Maintain ambient temperature and humidity. Results: Twenty days later,the skin damage caused by electric burns was reduced from 30% to 1%. Conclusion: These are very important links: The intake and output volume were actively controlled, The balance of intake and output was maintained for 24 hours, and lactic acid was less than 2mmol/L. Albumin supplementation Controlled above 30g/L, Debridement and dressing change were performed daily, Covered with nano-silver ion dressing, Try to ensure a sterile environment during operation, Maintain ambient temperature 28~30℃ and humidity 40%~50%.

Case Report and Review of the Literature: Human Amniotic Membrane in the Management of Burn Wounds

High-voltage electrical burns often have a deeper extent and cause more damage to surrounding soft tissue than injuries caused by fire burns or scalds. For the treatment of burn injuries there are dressings, dermal analogues, temporary skin substitutes; which favor the re-epithelialization of the wound bed, accelerating the healing process and some of them having specific properties. We present a case of a 41-year-old man who suffered high-voltage electrical burns on the face, neck, thorax, abdomen, upper limbs, and lower limbs. He underwent surgical cleaning at the day of his hospital admission, 7 days later a second surgical cleaning was performed with placement of human amniotic membrane in thoracic and abdominal burns. 10 months after the burn, the patient presents complete recovery of his burn injuries, hyperchromic scars with no evidence of pathological healing. As neurological sequelae, he presented polyneuropathy secondary to electrocution. We conclude that the amniotic membrane is an excellent substitute for temporary skin, useful for promoting the epithelialization of bloody areas from burns and reducing the local inflammatory response. Conclusion: The comparison between robotic-assisted liver surgery and laparoscopic surgery shows that the average medical cost was higher in robotic surgery when compared to laparoscopic liver cancer.

Expediting venous drainage in large anterolateral thigh flaps for scalp electrical burns in India: two case reports on the use of primary vein grafts for second vein anastomosis

Large scalp defects resulting from high-voltage electrical burns require free flaps, preferably skin, to permit optimal coverage and enable future or simultaneous cranial vault reconstruction. The anterolateral thigh permits the harvest of a large area of skin supplied by a reliable perforator. The superficial temporal vessels offer the proximate choice of recipient vessels to enable adequate reach and coverage. The lack of a second vein at this site implies the inability to perform a second venous anastomosis; however, this obstacle can be overcome by using an interposition vein graft, to the neck veins primarily. This assures adequate venous drainage and complete flap survival.

Selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle

Objective: To explore the selection strategy of pedicled axial flaps for repairing high-voltage electric burn wounds in foot and ankle. Methods: The retrospective observational research method was used. From January 2017 to December 2022, 16 patients with skin and soft tissue defects in foot and ankle after high-voltage electric burns were treated in General Hospital of Eastern Theater Command, including 11 cases of unilateral defect and 5 cases of bilateral defect. All patients were male, aged from 25 to 75 years. After thorough debridement, the area of the defect to be repaired with the flap was 5.0 cm×4.0 cm to 12.0 cm×8.0 cm. Before operation, the color Doppler ultrasound, computed tomography angiography, or digital subtraction angiography was used to fully evaluate the degree of vascular injury in the affected limb and to identify the distribution and traffic anastomosis of vascular network. Pedicled axial flaps with reliable blood supply were used to repair the wounds as soon as possible, and the area of flaps ranged from 3.0 cm×2.0 cm to 13.0 cm×8.0 cm. The wound in the donor area of flaps was repaired with split-thickness skin graft from head or medium-thickness skin graft from thigh. The flap repair of wounds in various areas of the ankle and foot was recorded. The postoperative survivals of the flaps and skin grafts were observed after surgery. The postoperative appearance of flaps and walking function of patients were followed up. At the last follow-up, the foot and ankle function was evaluated and rated using the American Association of Foot and Ankle Surgeons Ankle Posterior Foot Scoring System. Results: Two wounds in toe area were repaired with reverse dorsal pedis flaps, 3 wounds in medial ankle area and 2 wounds in heel area were repaired with medial plantar flaps, 2 wounds in anterior plantar area combined with toe area were repaired with reverse medial plantar flaps, 2 wounds in anterior plantar area combined with toe area and 5 wounds in anterior plantar area were repaired with reverse medial pedis flaps, 1 wound in toe area was combined with proper plantar digital artery flap, 1 dorsal pedis wound and 1 lateral malleolus wound were repaired with lateral supramalleolar perforator flaps, and 1 lateral malleolus wound and 1 dorsal pedis wound were repaired with sural neurovascular flap. One flap had venous reflux disorder after surgery and survived after treatment, while the other flaps and skin grafts survived completely after surgery. During the follow-up of 6 to 24 months after operation, the appearance of the flaps was good, and the walking function of patients was normal. At the last follow-up, the functional score of foot and ankle was 76 to 95, which was evaluated as excellent in 11 cases and good in 5 cases. Conclusions: According to the condition of high-voltage electric burn in foot and ankle, early and thorough debridement, preoperative imaging examination to evaluate blood vessels of the affected limb, and selection of pedicled axial flap with reliable blood supply are good methods for wound repair and related functional reconstruction of high-voltage electric burn in foot and ankle.

Oxidative stress mediates hippocampal neuronal apoptosis through ROS/JNK/P53 pathway in rats with PTSD triggered by high-voltage electrical burn.

The pathogenesis of post-traumatic stress disorder (PTSD) triggered by high-voltage electrical burn (HVEB) remains unclear and the oxidative stress plays a role in this process. The purpose of this study is to investigate the underlying mechanism of oxidative stress mediates hippocampal neuronal apoptosis in rats with PTSD triggered by HVEB. The PTSD rat model was developed by stimulating with high voltage electricity and screened using behavioral performance including Morris water maze (MWM), elevated plus-maze (EPM) and open-field test (OFT). The reactive oxygen species (ROS) generation was measured by DHE fluorescence staining or flow cytometry. Western blotting assay was used to detect the proteins of p-JNK, JNK, P53, PUMA, Bcl-2 and Bax in hippocampal tissue or HT22 cells treated with electrical stimulation. The serum MDA and 8-OHdG levels were increased (P < 0.001), while the activities of SOD and CAT were decreased (P < 0.001) significantly in patients with HVEB. Behavioral test results showed that high-voltage electric stimulation induced the PTSD-like symptoms and the ROS-JNK-P53 pathway was involved in the neuronal apoptosis in rats with PTSD induced by HVEB. In vitro experiments further confirmed the electrical stimulation induced neuronal apoptosis through ROS/JNK/P53 signaling pathway and the antioxidant NAC could rescued the ROS generation, activation of JNK/P53 proteins and improved the cell apoptosis rate in HT22 cells. Finally, the JNK inhibitor SP600125 could significantly inhibited the percentage of HT22 cell apoptosis induced by electrical stimulation (P < 0.001). These results indicated that oxidative stress mediates hippocampal neuronal apoptosis through ROS/JNK/P53 pathway in rats with PTSD triggered by HVEB.

Mechanism and prevention and treatment strategy of progressive injury in high-voltage electric burns

High-voltage electric burn is one of burns that can cause severe damages to tissue and organs. Clinically, progressive injury in high-voltage electric burns is a key pathological change that affects the level of amputation and the success rate of treatment. At present, the exact definition and mechanism of progressive injury in high-voltage electric burns have not been elucidated, and the clinical treatment is mainly symptomatic treatment. Relevant research data on the mechanism and treatment of progressive injury in high-voltage electric burns are lacking. This paper analyzes and summarizes the mechanism, diagnosis, treatment, and common outcome of progressive injury in high-voltage electric burns, and provides a reference for the mechanism research, clinical diagnosis and treatment of progressive injury in high-voltage electric burns.

An Observational Study on Levels of Serum Fibrin Degradation Product (FDP), D-Dimer and Procalcitonin in Burn Sepsis

Background: Despite improvements in burn management, infection is still the biggest challenge in major burn cases globally. Burn causes extensive tissue destruction, immune dysfunction, increases the risk of infection and septicemia with high morbidity and mortality. The aim of this study was to observe the levels of serum fibrin degradation product (FDP), D-dimer and procalcitonin in patients with burn sepsis treated in intensive care unit (ICU). Materials &amp; Methods: This observational study was carried out in Department of Burn and Plastic Surgery, Dhaka Medical College Hospital, Dhaka from February 2018 to January 2019. Forty (40) patients with major burns, from (15% to 50% total body surface area burn) with burn sepsis, were recruited for the study. In all cases, plasma level of fibrin degradation product (FDP), D-dimer and procalcitonin were measured and recorded. Result: Male predominance (57.5%) was observed in our study. Eighty five percent (85%) patients had total body surface area burn (TBSA) 20% to 50%. Sixteen patients (40%) suffered from flame burn, 13 (32.5%) patients from scalds and 11 (27.5%) patients had high voltage electric burn. The value of FDP was raised in 62.5% patients, D- dimer in 67.5% patients. Serum procalcitonin level was high (&gt; 2ng/ml), indicating burn sepsis in 47.5% cases but it was not significant (2 sample t – test reveals no significant relationship between rise of serum level of procalcitonin and presence of burn sepsis) Conclusion: Fibrin degradation product (FDP) and D- dimer were raised in two-thirds of burn cases while procalcitonin in two-fifths cases. Measurement of serum level of FDP, Ddimer and procalcitonin may give an idea regarding early onset of bacterial infection and burn sepsis and can serve as an indicator for burn sepsis. J Bangladesh Coll Phys Surg 2023; 41: 193-197

Effects of vitamin C combined with rbFGF on inflammatory factors and oxygen environment in patients with high-voltage electrical burns.

To investigate the effect of vitamin C combined with recombinant basic fibroblast growth factor (rbFGF) on inflammatory factors and oxygen environment in patients with high-voltage electrical burns. A retrospective analysis of 98 patients with high-voltage electrical burns admitted to our hospital from January 2021 to April 2022. A total of 98 patients were divided into research group and control group, including 49 cases treated with vitamin C combined with rbFGF and 49 cases treated with only rbFGF. The disappearance time of clinical symptoms, wound healing rate, area of granulation tissue growth, level of inflammatory factors, oxygen environment were compared between two groups after one and three courses of treatment. After treatment, the disappearance time of erythema, pain, swelling, blisters, exudate symptoms, wound healing time, scab formation time, and hospitalisation time in the research group were significantly better than those in control group (P < .05). There was no significant difference in the wound healing rate and area of granulation tissue growth between the two groups after one course of treatment (P > .05), while it is significantly better than those in control group after three courses of treatment (P < .05). The inflammatory factors, succinate dehydrogenase (SDH), lactate dehydrogenase (LDH) scores in research group were significantly better than that in control group after three courses of treatment (P < .05). Vitamin C combined with rbFGF may be worthy to reduce inflammatory factors, regulate oxygen environment, which can be popularised and applied in clinical practice.

Çocuklarda Düşük ve Yüksek Voltajlı Elektriksel Yanıklar: On Yıllık Deneyim

Objective: Burn injuries are an important public health problem for all ages. Due to electrical burns high mortality and morbidity rates, they should be evaluated differently from burns from other sources. This study aims to determine factors associated with high-and low-voltage electrical burns in children. Materials and Methods: The records of 72 patients who were treated for electrical burns were analysed. Electrical burns were divided into two groups: low and high voltage. Demographic data, treatment, outcomes were compared between the two groups. Results: In this study, low-voltage electrical burns were detected in 83.3% of the patients, and high-voltage electrical burns were detected in 17.7% of the patients. High-voltage burns were more common in rural residents (p&amp;lt;0.05). Low-voltage electrical burns mostly occurred as a result of home accidents (90%), while high-voltage injuries were mostly caused by work accidents (100%), (p&amp;lt;0.05). The most common cause of low-voltage injuries was contact with an electrical outlet (91.6%), for high-voltage injuries it was contact with a transformer (83.3%) (p&amp;lt;0.05). For high-voltage injuries, the severity of the burns was higher, the duration of the hospital stay was longer (p&amp;lt;0.05). Conclusion: Children generally have low-voltage injuries. High-voltage injuries are associated with more surgical treatment and morbidity, longer hospital stays. Electrical burns can be reduced by training on protective measures and proper arrangement of infrastructure in rural areas

Cosmetic and visual outcomes following high-voltage severe electric facial and ocular burns: A case report

A 19-year-old male presented with accidental high-voltage electric burns following contact with a transformer while catching ball and developed right eye count finger vision and no perception of light in left eye. On examination, there were full thickness burns on upper half of left side of face, lids, and left leg involving 3rd, 4th, and 5th toes. Three surgeries were performed by the plastic surgeon for overall aesthetic look. The right eye regained vision following cataract surgery, but there was cosmetic and functional loss of left eye. This case report highlights that high-voltage electric burns of face and eye require proper surgical management and final visual outcome depends on amount of damage.15

Psychosocial Impact of Electrical Burn in Children: A Follow-Up Study Conducted at a Tertiary Care Hospital.

Introduction Electrical burn injuries are very common in the pediatric population and are usually accidental and sometimes occupational. The objective of our study was to evaluate the epidemiology of electrical burn injuries and prospectively evaluate the long-term psychosocial impact of electrical burn injuries in children. Materials and methods A qualitative interview study was conducted prospectively among sixty patients presented to Holy Family Hospital, Rawalpindi, Pakistan. Demographic details, mode of presentation, detail of injury, total body surface area, initial condition, and surgical interventions were noted during their stay at the hospital. Their physical and psychological outcomes were evaluated by administering the Strength and Difficulties Questionnaire (SDQ) and Body Dysmorphic Disorder Questionnaire (BDDQ) via telephonic interviews after six weeks of discharge from the hospital. The study was conducted over a span of 1 year from January 2021 to January 2022. Results There were 60 patients who presented to the department of pediatric surgery during the span of the study. The mean age was 9.9 years ± 3.133 years (SD) and 80% of the patients were above 8 years of age with a male-to-female percentage of 86.67% to 13.33%, respectively. Forty-two (70%) patients incurred high-voltage electrical burns while 18 (30%) suffered low-voltage electrical burns. Mortality was 13.33% (n=8). Out of 52 patients who survived, 35 (67.30%) were labeled as having Body Dysmorphic Disorder upon administration of BDDQ through a six-week follow-up. The majority of the patients had abnormal or borderline results in different scales of SDQ. Conclusion The long-term psychological stress and the varied spectrum of psychiatric disorders in electrical burn patients are profound. The prevention of burn injuries can be effectively achieved by educating parents about safety measures and improving health infrastructure. Implementation of a dedicated national program for psychological support of burn patients should be made accessible to all patients.

Upper Limb Amputations Following Electric Burn: Experience Sharing from Tertiary Hospitals in Bangladesh

Introduction: High voltage electrical burn is one of the most devastating burn injuries involving upper limbs in Bangladesh. It causes serious disfigurement and may lead to loss of the whole upper limb. The aim of this study was to see the severity of electric burn injury involving upper limbs pausing amputations at different levels in two tertiary level referral hospitals of Bangladesh. Methods: A prospective observational study was designed to collect the data from Burn and Plastic Surgery Unit, Dhaka Medical College Hospital and Sheikh Hasina National Institute of Burn and Plastic Surgery from January 2019 to December 2019. One hundred and sixty-nine (169) patients with high voltage electrical burn injury involving upper limb underwent amputation were analyzed according to the severity based on clinical assessment. Results: Male predominance (89%) was observed where right upper limb was involved in 49% of the cases and in 11% cases amputation was bilateral. The most alarming finding was 57.4% patients were below the age of 21 years. Below elbow amputation was done in 48.5% cases followed by above elbow amputations in 32.54% cases. Conclusion: Male sex and younger age are the two most common association with electric burn and subsequent limb amputation. The incidence in higher in upper limbs. This study will help us to create the awareness and for prevention of electric burn. J Bangladesh Coll Phys Surg 2022; 40: 279-286

Features of providing medical care to patients with extensive high-voltage electric burns

Electrical injuries are a serious problem around the world. Patients with extensive, high-voltage electric burns belong to the group of severely burned. Timely and adequate treatment, which includes intensive anti-shock measures in the first days after injury, with simultaneous active surgical tactics, is decisive for saving life for such victims. The provision of specialized, high-tech medical care for these complex patients is optimal in conditions of a burn department / center of a multidisciplinary medical organization. However, knowledge of the basic principles of providing emergency and urgent medical care to victims with electrical trauma even before admission to the burn hospital is the key to their further successful treatment.

Prevalence of Cardiac Arrhythmias, Clinical Spectrum and Complications of Electrical Injury

Background: Electrical accidents (EA) are rare, but can cause serious and potentially life-threatening injuries to multiple organs. The majority of epidemiological data refers to workplace accidents which account for a significant share of such accidents in adults. Exposure to electric shock has been associated with an increased risk of developing immediate and delayed cardiac arrhythmias. Objective: To evaluate the prevalence of cardiac arrhythmias and different symptoms in patient with high voltage and low voltage electrical injury. Methods: This was observational prospective study was carried out at the Dept. of Cardiology, Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh from January to June 2021. 51 consecutive patients with electrical injury who were admitted. Admission criteria were age ≥15 years, loss of consciousness, cardiac arrest, electrocardiographic abnormalities, soft tissue damage and burns. Patients were categorized into high and low voltage injury group and their variables were compared. Results: The mean age of the patients was 32.3±10.4 years among them 41 (82.3%) were male. Patients who sustain high voltage electrical injury (&gt;1000V) were 18 (35.2%) and low voltage injury (&lt;1000V) were 33 (64.7%).Cardiac arrhythmias like sinus tachycardia (11.1% vs 6.0%, p=0.054), sinus bradycardia (11.1% vs 3.0% p=0.254), ventricular premature beats (5.6% vs3.0%, p=0.674), atrial fibrillation (11.1% vs 0%, p=0.054) were observed in high voltage and low voltage group. The commonest presenting symptoms in both groups were pain (77.8% vs 81.8% p=0.560) and fatigue (55.6% vs 39.3%, p=0.328). Conclusion: In this study few non-fatal cardiac arrhythmias were observed in both high and low voltage electrical injury group. Parameters considered to be risk factors such as known structural heart disease, loss of consciousness, high voltage electric shock, burn and soft tissue injuries were also not significant predictors of the occurrence of arrhythmias. There is no significant difference in the presenting symptoms and types of arrhythmias observed between low voltage and high voltage injury group.

We Got Your Back: Evaluating Recovery Following Spinal Cord Injury After High-Voltage Electric Burns.

Delayed spinal cord injury (SCI) is a relatively rare consequence of high voltage electrical burns, but it holds significant implications for patient quality of life. Due to the uncommon nature of delayed SCI and variable time of onset following injury, providers are currently unable to provide a prognosis for functional recovery and optimize a therapy process tailored to treat this patient populace. In this study, we aim to better map the pattern of recovery in these patients to better inform future rehabilitation practices. A retrospective chart review of five patients who experienced delayed SCI secondary to an electrical burn was conducted. The majority of patients displayed an upward trajectory in motor function following acute hospitalization and inpatient rehabilitation, with four of the five patients able to achieve complete motor strength in multiple extremities. In addition, rehabilitation was shown to have a noticeable impact in improving functional independence in tasks related to nursing. In conclusion, the clinical and functional outcomes of these delayed SCI patients point to the need for multidisciplinary management following injury and highlight the importance of early rehabilitation in regaining function.

Hyperbaric oxygen therapy in low extremity trauma: A case series

IntroductionTrauma to the extremities is a common major health problem that requires special attention because it can have a dangerous impact on both the viability of the limb and the patient's life. Hyperbaric oxygen therapy is an alternative therapy hypothesized to improve the prognosis in lower extremity trauma. Case presentationWe present a series of 7 cases of lower extremity trauma treated with hyperbaric oxygen therapy: soft tissue loss, neglected chronic burn injury, high-voltage electrical burn, gas gangrene, crush injury, chemical burn, and excoriation with skin loss. DiscussionHyperbaric oxygen therapy involves giving 100% oxygen in a chamber at pressures above atmospheric pressure (2–3 atm absolute [ATA]). It can increase oxygen delivery to peripheral tissues with vascular compromise, cytogenic and vasogenic edema, and cellular hypoxia caused by limb trauma. ConclusionHyperbaric oxygen therapy has many benefits in lower extremity trauma for wound recovery, preventing complications, and helping patients return to daily activities.

BILATERAL SHOULDER DISARTICULATION FOLLOWING HIGH VOLTAGE ELECTRIFICATION: CASE REPORT

The high voltage electrical burn is a rare but very serious incident involving the vital and functional prognosis. It generally occurs in young active subjects and in professional environments, especially in the context of work accidents. Tissue damage is immediately disastrous and requires multidisciplinary management. The recourse to amputation or bilateral disarticulation leads to a serious disability with a heavy socio-professional and psychological repercussion, hence the interest of prevention and awareness. We report the case of a 35 years old patient who suffered a high voltage electrification of both upper limbs during a false manipulation of high voltage cables.

Cranial-entry electrical burns with neurological sequelae: A case report

Cranial-entry high-voltage electrical burn injury rarely occurs. Hence, early presentation is rare. We herein present a case of a teenage male with mainly fullthickness electrical burn injury covering 9% of the total body surface area, with gangrenous mid-fronto-parietal scalp and calvarium, moderate head injury with bihemispheric deficits, and left frontoparietotemporal intracerebral hematoma and exit wounds (right thumb, thigh, and toes). He underwent initial outer-strip and, later, inner-strip corticectomy, covered with splitthickness skin graft (STSG) and bilateral posteriorauricular artery-based flap, respectively, as well as tangential burn wound excisions with STSG and louvre flap cover for the digits. He also underwent right upper eyelid contracture release and tarsorrhaphy. He developed late post-traumatic seizures, which were managed with anti-epileptic drugs. Definitive calvarial reconstruction is underway. Cranial-entry electrical injury had high morbidity and mortality risks. The spectrum of nervous damage causation mimics nervous syndromes and their presentations. Although elaborate surgical and medical care offers the possibility of survival, the neurological and neuropsychological syndromes in the post-acute and rehabilitative phases of care should be taken care of.

Challenges in the Rehabilitation Management of a Patient with Spinal Cord Injury Without Radiographic Abnormality (SCIWORA) Secondary to High-voltage Electrical Burn Injury with Multiple Disabilities: A Case Report

A 22-year-old male who came in contact with a high-voltage wire, with entry point at the head and exit points at the ankles, presented with flaccid paraplegia and loss of sensation of bilateral lower extremities with no radiographic abnormalities. Several burn-related medical complications arose during the admission, as well as episodes of demotivation. Bilateral below the knee amputation was done because of extensive burn injuries of the lower extremities. The rehabilitation management for a patient with multiple disabilities needed to be tailored depending on the limitations and needs of the patient at a certain point in time. Despite the challenges, satisfactory results were achieved, through telerehabilitation and employing a multidisciplinary team approach.