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

Abstract

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

Epidemiology of hand surgical cases operated in tertiary referral centers in Dhaka

“…11% female) was observed. 13 Hand injuries represent up to 20% of all injuries treated in emergency unit. 14 Majority of the cases were unsupervised by specialist.…”

“…Here, deformity correction (17%), nerve repair and reconstruction (13.6%), tendon repair and reconstruction (12.5%), PBSC (10.5%), flap (9.8%), tumor excision (9.2%), others (8.7%), fracture According to Begum et al most electrical burns affected the upper extremities and the usual level of amputation was below the elbow (48.5%), the second was above the radiation amputated elbow (32.54%), amputation because of ray 9.46%, amputation of multiple fingers 7.01%, the shoulder joint disarticulation in 1.77% cases, right hand 49%, left hand 40%, bilateral involvement in 11% cases. 13 According to Nwadinigwe et al 49.4% of high voltage injury victims needs amputation, mainly upper extremities as the hand is the normal primary point of contact. 17 This study shows that extensor tendon injuries are more common than flexor tendon injuries the index finger represents the most common injuries of finger.…”

“…The impact of hand trauma on individuals and the community are significant and according to national electronic injury surveillance system "NEISS", laceration of finger and hand fractures are most commonly affected anatomical sites by work-related injuries in the United States emergency service. [10][11][12][13][14][15] It is well known that for optimum outcomes there is a need for competencies in the management of hand injuries and in spite of the existence of a national hand surgeon society there is a need for greater numbers of practicing surgeons competent in the skills needed for hand surgery and access to their services by the population. 11,16 Surgical volunteerism by female plastic and reconstructive surgeons (Reconstructing Women International, RWI) from India, Pakistan, Kenia, Tanzania have provided access in urban primary health care centers.…”

Physiotherapy Approach in Transradial Amputation Following the Sequelae of Electric Burn: A Case Report

“…Despite the best care, full-thickness circumferential burns and electrical burns could ultimately necessitate amputation [ 13 ]. The most devastating consequence of burn injuries is the loss of a limb; therefore, opting to amputate a severely burned limb is essential for increasing the patient's chances of survival and minimizing morbidity [ 14 ]. With an incidence of as much as 68 percent, burns caused by electricity have a direct connection to an increased probability of amputation [ 15 ].…”