Electrical injuries comprise only a small fraction of burn injuries admitted to specialized centers. High voltage injuries may not be survivable. The flow of current through the body interferes with tissues conducting electricity on their own (nerves, heart) and expends its energy on tissues with highest resistance, the bones, causing high temperature damage from the “inside out”. In close proximity to the long bones of the extremities run the bundles of nerves, arteries and accompanying veins and bones serve as attachments and origins of muscles. These elements suffer damage and due to the “inside out” pattern only the tip of the iceberg is visible on the skin (say entry/exit sites). Symptoms and findings from damage by current are thus extremely variable mimicking a gamuth of unrelated, but often equally dangerous diagnosis, thus the term “great masquerader” given to electrical injuries.
It is not frequent for plastic surgeons to be involved in life threatening clinical scenarios, but in the case study published recently by Trinidad Institute of Plastic Surgery’s lead surgeon (and on display below) our team really saved somebody’s life.
So with a salute to the good old times (no, in fact great old times) and the 2005 team at Tampa Bay Regional Burn Center, Tampa, Florida – C. Wayne Cruse MD, Arno R. Schleich MD, Hans Schweiger MD, Attila Becsey MD, Naleenie Singh RN, BS, CCRN, TNCC, MHSA, MBA (yes, Trinidad Institute of Plastic Surgery’s esteemed CEO, at that time head nurse of the burn center) – when reading through that case I am still amazed we pulled it off !
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