Patterns of high tension electrical injury in children and adolescents and their management.

High tension electrical burn injury occurred in twenty-nine patients over a period of seven years, causing two deaths, and demonstrating two reasonably distinct patterns. Major surface thermal burns from involvement in an electric arc, augmented by flame burns of ignited clothing, occurred in eleven patients. By contrast, eighteen children demonstrated wounds of entrance and exit of current and varying effects of deep thermal injury along the path of the maximally conductive blood vessels and nerves of extremities. An aggressive surgical approach was taken in patients with both types of injury, with the objective of prompt identification and excision of devitalized tissues and closure of thw wound. In the deep condictuve type of injury, frozen section and subsequent histologic study served as a guide to adequacy of excision and preservation of viable tissue. Even so, amputation of fifteen extremities and four other major excisions were required in twelve patients.