Coverage of the Hand and Forearm in Electrical Burn

Abstract

Purpose:The hand and forearm are the common points of contact and entry for electrical burns. Wounds from electrical burns can range from small to large and superficial to deep. High-voltage electrical burns result in skin and/or soft-tissue defects owing to progressive necrosis caused by intravascular thrombosis, causing complications in the coverage of electrical burns. Various coverage methods have been used for electrical burns on the hands and forearms.Methods: Between 2017 and 2022, 61 patients were admitted for electrical burn treatment on the forearm and hand in our department; and 41 underwent coverage surgery. The range of motion was evaluated when feasible pre-and post-operatively.Results: Among the 41 patients who underwent coverage surgery, 16 and 25 suffered deep second-and third-degree burns, respectively. Wounds of the remaining 20 healed with wound dressings as they were superficial or small. Patients with deep second-degree burns required various procedures, including full-thickness skin graft (FTSG), advanced local flap, split-thickness skin graft (STSG), and STSG with acellular dermal matrix (ADM). Procedures for patients with third-degree burns include an advanced local flap, STSG with ADM, FTSG, and other flap surgeries. All the wounds healed without major complications. Conclusion:We successfully treated 41 burn wounds using different wound coverage methods, such as STSG or STSG with ADM for deep second-degree burns and flap surgery for third-degree burns. Moreover, in third-degree burns, STSG with ADM could substitute for flap surgery if flap surgery is not performed.