Electrical Injury (a Literature Review)

Abstract

The analysis of domestic and foreign literature sources showed that the problem of diagnosing and treating electrical injuries remained relevant as in the early 20th century. Over the past century, the mechanisms of the effects of electric current on organs and tissues have been well studied. However, the search for methods for diagnosing the volume of tissue damage has not been completed, and such methods are necessary, since they are designed to help determine the volume of surgical intervention. Many patients still require repeated surgical interventions to completely excise necrotic tissue. In most patients with severe electrical trauma, reconstructive surgery takes place in several stages. Today, most clinical data and practical recommendations are based on the opinions of individual experts and limited clinical studies.Authors declare lack of the conflicts of interests.

Hidden realities of electrical injuries

“…Direct current (DC) travels in only one direction, whereas an alternating current (AC) flows back and forth due to alternating voltage drops across the conductor. In most countries, a victim of electrical shock has experienced a commercial 50-60 cycle AC electrical current that alternates direction twice per cycle 5. At this frequency, the current passing through the body changes direction 100-120 times per second, thereby rendering the commonly used terms “entrance wound” and “exit wound” misleading; the current goes in and out of all contact points repeatedly, so these wounds can be more accurately described as “contact wounds.” If the skin is wet, internal electrical injuries may occur without clinically obvious skin contact wounds.…”

“…However, the severity of electrical shocks is far more complicated than a simple “low versus high” voltage classification. Several factors influence the severity of electrical injury including shock voltage, shock duration, the path of the electrical current, and affected tissues (see Key definitions ) 5. The contact voltage is usually defined as the voltage of the electrical power source contacted by the shocked individual.…”

“…If the electrical potential at one point of contact is greater than the electrical potential at the other point of contact, then current will flow between the two points in what is known as an electrical shock. Additional parameters to consider include variations in body size and the presence of protective gear 5…”

“…There is often no time for a complete engineering evaluation; the acute care clinicians must depend on their clinical experience to determine the extent of workup and treatment. Clinical monitoring is important to reduce the risk of missing life-threatening injuries 5. To that end, this article discusses some fundamental concepts and misunderstandings that surround electrical injuries.…”

Reconstructive Surgery for High-voltage Injury of Genitoperineal Area and Upper Extremities: The Uromanual Trauma Concept

“…The first case of high-voltage injury was reported in 1879: a French carpenter suffered extensive soft tissue defects after contacting an alternator, which led to his death. 1 Injuries caused by high-voltage electrical currents are considered to be among the most devastating due to the high level of damage and mortality rate, general severity, long rehabilitation period, and difficulties in perioperative planning. 2 Electrical traumas are divided into low-voltage (under 1000 volts) and high-voltage (over 1000 volts).…”