G09 Disastrous consequences of electrical injuries of upper limb following suicidial attempts

Autor/Author: Botan A.

Pracoviště/Workplace: The Burn Centre & Plastic Surgery Dept, Teaching Hospital of Targu Mures Medical School, Romania.

Délka prezentace/presentation time: 7 min.

Summary:

Introduction: electrical Injuries are severe complex traumas due to the multiple effects of the electric energy when touching the human body. According with the way in which the electric energy is acting on the living tissues, there are several types of electrical injuries: electrocution, electric arc, and electric flame, natural flash burns and so on. The hand surgeon has usually to face a combination of two or three of the above mentioned electric traumas (for instance a combination between an electrocution and an electric flame, igniting the clothes of the victim). There are also several types of electric currents to which the human body may be exposed accidentally (direct or alternating current, low voltage, high voltage, ultra-high voltage, and so on).

Material and Method: medical classification divides the electrical injuries in “low-voltage traumas” (due to the contact with an electric current <1000V), and “high-voltage traumas”( due to the contact with an electric current >1000V). In the last years, a very common and “in fashion” suicidal attempt (among young people under thirty, especially) was by climbing the electric poles and grasping the power lines. All these patients suffered multiple traumas (electrocution, flame burns, different fractures due to the fall from the electric pole and so on), requiring a qualified, intensive and complex medical care in the Burn Unit. The medical care protocol has the usual steps as follows: fluid resuscitation by one or two CVC (central venous catheters), early debridement of all eschars and necrotic tissues, internal either external fixation of fractures, amputations when required, or careful treatment of the possible complications, cardiac, respiratory, renal and so on). The remaining excisional defects are usually skin-grafted with STSG and sometimes by distant flaps like the groin flap either latissimus dorsi flap 

Results and Discussions: all the patients included in this study have survived the suicidal attempt but with terrible consequences (loss of the hand, of the fore-arm, extensive mutilating scars, permanent destruction of important motor nerves, etc).

Conclusions: electrical injuries due to suicidal attempts have disastrous consequences for the most part of victims (upper limb amputations with permanent mutilations and scaring, neurologic complications and other permanent invalidities), requiring handicap compensations either invalidity pensions, meaning a huge financial burden and effort for the society. Beside this, such severe traumas require a very high cost for the very long and complex medical care. Unfortunately, there is no efficient way to prevent these accidents that seem to be more and more frequent in the last years.