Wound management and outcome of 595 electrical burns in a major burn center

2017 ◽  
Vol 214 ◽  
pp. 182-189 ◽  
Author(s):  
Haisheng Li ◽  
Jianglin Tan ◽  
Junyi Zhou ◽  
Zhiqiang Yuan ◽  
Jiaping Zhang ◽  
...  
Keyword(s):  
Wound Management ◽  
Burn Center ◽  
Major Burn ◽  
Electrical Burns

scholarly journals A case of burn evisceration with full-thickness injury to abdominal wall, bowel, bladder, and three extremities

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Davit Shahmanyan ◽  
Matthew T. Joy ◽  
Bryan R. Collier ◽  
Emily R. Faulks ◽  
Mark E. Hamill
Keyword(s):  
Small Bowel ◽  
Abdominal Wall ◽  
Damage Control ◽  
Electrical Injury ◽  
Full Thickness ◽  
Damage Control Laparotomy ◽  
Burn Center ◽  
Major Burn ◽  
Electrical Burns ◽  
Lower Abdominal Wall

Abstract Background Severe electrical burns are a rare cause of admission to major burn centers. Incidence of electrical injury causing full-thickness injury to viscera is an increasingly scarce, but severe presentation requiring rapid intervention. We report one of few cases of a patient with full-thickness electrical injury to the abdominal wall, bowel, and bladder. Case report The patient, a 22-year-old male, was transferred to our institution from his local hospital after sustaining a suspected electrical burn. On arrival the patient was noted to have severe burn injuries to the lower abdominal wall with evisceration of multiple loops of burned small bowel as well as burns to the groin, left upper, and bilateral lower extremities. In the trauma bay, primary and secondary surveys were completed, and the patient was taken for CT imaging and then emergently to the operating room. On exploration, the patient had massive full-thickness burns to the lower abdominal wall, five full-thickness burns to small bowel, and intraperitoneal bladder rupture secondary to full-thickness burn. The patient underwent damage-control laparotomy including enterectomies, debridement of bladder coagulative necrosis, and layered closure of bladder injury followed by temporary abdominal closure with vacuum dressing. The patient also underwent right leg escharotomy and partial right foot fasciotomies. The patient was subsequently transferred to the nearest burn center for continued resuscitation and comprehensive burn care. Conclusion Severe electrical burns can be associated with devastating visceral injuries in rare cases. Though uncommon, these injuries are associated with very high mortality rates. The authors assert that rapid evaluation and initial stabilization following ATLS guidelines, damage-control laparotomy, and goal-directed resuscitation in concert with transfer to a major burn center are essential in effecting a successful outcome in these challenging cases.

625 Death Due to Fractal Wood Burning: An Emerging Public Health Problem

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S158-S158
Author(s):  
Harold Campbell ◽  
Rabia Nizamani ◽  
Samuel W Jones ◽  
Bruce Cairns ◽  
Felicia N Williams
Keyword(s):  
Public Health ◽  
Upper Extremity ◽  
High Voltage ◽  
Health Problem ◽  
Public Health Problem ◽  
Online News ◽  
Voltage Transformer ◽  
News Reports ◽  
Burn Center ◽  
Electrical Burns

Abstract Introduction The art of pyrography, creating designs in wood with a thermal heat source, dates back to prehistory. Risks include cutaneous burns and airway injury. Fractal woodburning is a niche method of pyrography utilizing a high-voltage electrical source to burn branched designs – Lichtenberg patterns – into the surface of wood. While this technique has grown in popularity, the associated risks are not well described. Methods We describe a patient who presented to our burn center after sustaining high-voltage electrical burns from a homemade high-voltage device constructed for fractal woodburning. We also evaluated publicly reported cases of death or injury due to this technique. Results An otherwise healthy 17-year-old male was admitted to our burn center with injuries sustained while making fractal wood art. The patient improvised a high-voltage transformer from a discarded microwave, generating 2000 volts from household current. While using this device to burn Lichtenberg patterns in wood, he contacted the electrodes and sustained full-thickness electrical burns to the neck, chest, and bilateral upper extremities. Bilateral upper extremity fasciotomies were required on admission. Multiple subsequent operative procedures culminated with autografting to the majority of the wounds and ongoing complex reconstruction of the left thumb. In evaluating online news reports, we found 21 unique individuals with death or injury attributed to fractal woodburning. Four sustained substantial injuries, while 17 reportedly died. The first reported incident occurred in July 2016 and the most recent report was from July 2019. Ages ranged from 17 years old to the 60s. Eighteen individuals were younger than 50 years old. All of the mortalities and 3 of the 4 injuries occurred in males. Of the survivors, 3 sustained significant upper extremity injuries and 2 suffered cardiac arrest at the time of injury. The devices used in 4 incidents were microwave transformers and generated 2000 volts. Device characteristics were not identified in the remainder of cases. Conclusions Fractal woodburning is associated with devastating high-voltage electrical injuries and death. Prevention efforts should be focused on the potential risks of this art form. Applicability of Research to Practice News reports likely underestimate the actual incidence of injury and death due to fractal woodburning, however, even this limited data suggests an emerging public health problem requiring further study and public education.

Inpatient Data of Occupational Burn Injuries Treated at a Tertiary Burn Center

2019 ◽  
Vol 41 (2) ◽  
pp. 398-401
Author(s):  
Abdulkadir Basaran ◽  
Ozer Ozlu
Keyword(s):  
Hospital Stay ◽  
Burn Injury ◽  
Health And Safety ◽  
Length Of Hospital Stay ◽  
Burn Injuries ◽  
Occupational Accidents ◽  
Cross Sectional ◽  
Work Related ◽  
Burn Center ◽  
Electrical Burns

Abstract Occupational burns are among the important causes of work-related injuries. We aimed to investigate the epidemiology and reasons of occupational burns and thereby to emphasize preventive measures. Between January 2017 and December 2018, the data of major occupational burn injury patients admitted to our burn center were evaluated in this cross-sectional retrospective study. During the study period 342 patients older than 16 years were admitted to the burn center. Among them 80 patients with occupational burns (23.4%) were identified. The mean age of the patients was 34.73 ± 12.3 years. Seventy-eight patients (97.5%) were male. Electrical burns and flame burns were the two leading type of occupational burns. The most common occupation of our patients was construction work. Dangerous behavior, carelessness, lack of protective equipment, and failure to follow instructions were causes of injury. Only 14 patients (17.5%) experienced unavoidable accident. Thirty-seven patients (46.3%) worked on temporary basis. Occupational experience was under 5 years in majority of the cases (62.5%). For the occupational burns the percentage of burned TBSA was 17.08 ± 14.5 (1–60) and the length of hospital stay was 23.94 ± 21.9 days (2–106). There were no significant differences between occupational and nonoccupational burn injuries considering TBSA, total length of hospital stay, and complications (P > .05). Occupational burn injuries are common in less experienced and younger workers. Therefore, recognition of the problem and maintaining awareness is important. In order to prevent occupational accidents and burns, occupational health and safety rules must be obeyed.

746 Racial and Ethnic Disparities Among Burn Surgery Leadership

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S206-S206
Author(s):  
Francesco M Egro ◽  
Caroline E Kettering ◽  
Anisha Konanur ◽  
Alain C Corcos ◽  
Guy M Stofman ◽  
...  
Keyword(s):  
Group Representation ◽  
Minority Group ◽  
Ethnic Disparities ◽  
Full Professor ◽  
Academic Rank ◽  
H Index ◽  
Burn Care ◽  
Burn Center ◽  
Major Burn ◽  
Burn Surgery

Abstract Introduction The underrepresentation of racial and ethnic minority groups has existed and been well documented in general and plastic surgery literature but has not been described in burn surgery. The aim of this study is to evaluate current minority group representation among burn surgery leadership. Methods A cross-sectional study was performed in January 2019 to evaluate minority group representation among burn surgery leadership. Burn surgeons included were directors of American Burn Association (ABA)-verified burn centers in the US, past and current presidents of the ABA and International Society of Burn Injuries (ISBI), and editorial board members of five major burn journals (Journal of Burn Care & Research, Burns, Burns & Trauma, Annals of Burns & Fire Disasters, and the International Journal of Burns and Trauma). Surgeons were compared based on factors including age, gender, training, academic rank, and h-index. Results Among 71 burn center directors, 68 societal presidents, and 197 journal editors, minority ethnic groups represented 18.3, 7.4, and 34.5 percent, respectively. Among US burn center directors, the group classified collectively as non-white was significantly younger (white = 56 years, non-white = 49 years; p< 0.01), graduated more recently (white = 1996, non-white = 2003; p < 0.01), and had a lower h-index (white = 17.4, non-white = 9.5; p < 0.05) than white colleagues. There were no significant differences in gender, type of residency training, advanced degrees obtained, and fellowships completed between white and non-white groups.The were no significant differences in the likelihood of white and non-white directors in academia to be full professor, residency or fellowship director, or chair of the department.When compared to the 2018 US National Census, burn unit directors had a 5.1 percent decrease in non-white representation. Specifically, Asians had an 8.3 percent increase in representation, while there was a decrease in both Black (12.0%) and Hispanic (15.3%) representation. Conclusions Disparities in representation of ethnic and racial minorities exist in burn surgery leadership. The most extreme disparities were seen with Black and Hispanic surgeons. However, because these surgeons are younger and graduated more recently, it is promising that minority representation will continue to rise in the future. Applicability of Research to Practice Programs should be initiated in burn surgery that address the implicit biases of burn surgeons and increase mentorship opportunities for underrepresented minorities.

THE ADEQUACY OF LIMB ESCHAROTOMIES-FASCIOTOMIES AFTER REFERRAL TO A MAJOR BURN CENTER

1994 ◽  
Vol 37 (6) ◽  
pp. 916-920 ◽  
Author(s):  
Rebeccah L. Brown ◽  
David G. Greenhalgh ◽  
Richard J. Kagan ◽  
Glenn D. Warden
Keyword(s):  
Burn Center ◽  
Major Burn

scholarly journals Burn center care reduces acute health care utilization after discharge: A population-based analysis of 1,895 survivors of major burn injury

Surgery ◽  
2017 ◽  
Vol 162 (4) ◽  
pp. 891-900 ◽  
Author(s):  
Stephanie A. Mason ◽  
Avery B. Nathens ◽  
James P. Byrne ◽  
Robert A. Fowler ◽  
Paul J. Karanicolas ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Utilization ◽  
Burn Injury ◽  
Population Based ◽  
Care Utilization ◽  
Burn Center ◽  
Acute Health Care ◽  
Major Burn ◽  
Center Care

825 Electrical Injuries as a Result of Solar Panels: A New Trend

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S251-S252
Author(s):  
Ran Halleluyan ◽  
Nicole M Kopari
Keyword(s):  
Injury Severity ◽  
Average Length ◽  
Significant Proportion ◽  
Kidney Injury ◽  
Solar Panel ◽  
Solar Panels ◽  
Center Staff ◽  
Burn Center ◽  
Electrical Burns ◽  
Electrical Injuries

Abstract Introduction Solar panels are associated with a number of potential injuries from manufacturing through installation. Among these are electrical injuries, which increased in frequency with the recent increase in the production of photovoltaic panels. The burn literature is currently limited regarding these injuries, the aim of this study was to summarize our institutional experience with electrical injuries from solar panels. Methods A retrospective review of all electrical injuries evaluated at an ABA verified Burn Center from 2014–2018 was performed. Electrical burns unrelated to solar were excluded from analysis. Data collected included demographics, injury severity, and associated morbidity and mortality. Results A total of 39 electrical burns were treated during the study duration, 5 of which (13%) were related to solar panel production or installation. Two patients were burned while working in a solar factory, two while installing solar panels, and one while cleaning solar panels. The average age was 29 years (range 20–47) and all were male. All patients had < 5% TBSA; 1 patient had burns to the face, 1 had burns to the foot, 2 patients had burns to the hand/finger, and 1 patient had burns including the hands, abdomen, and thigh. One patient developed v-fib following his injury. He had a prolonged hospital stay of 74 days complicated by pneumonia, encephalitis, and acute kidney injury with rhabdomyolysis causing compartment syndrome of the hand which required fasciotomy. When excluding this outlier, the average length of stay was 2 days and none required ICU care. One patient required toe amputations and one presented with corneal abrasions, but no other significant complications including cardiac arrhythmias. All 5 patients survived. Conclusions Electrical burns from solar panels make up a significant proportion of electrical burns cared for at our institution. With the recent and continued rise in solar panel production and installation, burn centers should expect to see an increase in patients presenting with electrical burns associated with these products, especially in states seeing a greater push to adopt this technology. Applicability of Research to Practice Burn center staff should be aware of this emerging pattern and prepared to care for the patient injured though this mechanism.

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