电烧伤肢体缺失的临床模式研究。

Study of clinical pattern of limb loss in electrical burn injuries.

机构信息

Department of Burns, Plastic & Maxillofacial Surgery, VM Medical College & Safdarjung Hospital, New Delhi.

Dept. of Forensic Medicine, V.M. Medical College & Safdarjung Hospital, New Delhi, 110029, India.

出版信息

Injury. 2021 Jul;52(7):1925-1933. doi: 10.1016/j.injury.2021.04.028. Epub 2021 Apr 9.

DOI:10.1016/j.injury.2021.04.028

PMID:33902868

Abstract

INTRODUCTION

Electrical burn injuries are devastating and cause not only loss of life but also severe disabilities in the form of limb loss. Increase in urbanization, industrialization and overcrowding has led to an increase in electric injuries.

MATERIAL AND METHODS

The study was prospective in nature evaluating electric burns and studied the pattern of limb loss for a duration of 18 months from October 2016 to March 2018. Parameters recorded were demographic data, clinical data regarding the electrical injuries, complications, and outcomes.

RESULTS

Male patients made up 85.3% of cases. Mean TBSA was 24.76 ± 19.18%. Mean age was 27.59 ± 13.73 years. Pediatric patients made up 17%. High voltage burns constituted 68.2 %. Electric contact burn was the most common type making up 49.5% of cases. The most common cause was occupational (38.9%). A fasciotomy was required in 22% of cases with an amputation rate of 38% (209 out of 550). There were 190 major amputations and 106 minor amputations. Overall, the right upper limb amputations were twice as common as the left. The ratio of upper limb: lower limb amputation was 4:1. Fifty patients (23.9%) required revision amputation. The age group 11 to 30 years made up 55.5% of amputations. There was no statistical difference in amputation rates between males (31.31%) and females (41.97%). In patients with TBSA less than 25% amputation rate was 47.77% as compared to patients with more than 25% TBSA, 19.47% (p<0.001). Most amputations occurred due to electric contact burns (74.16%). In the high voltage group, 46.1% underwent amputation vs low voltage group -20.6% (p<0.001). Overall mortality rate was 12.7%. Three hundred patients (55%) had low level of awareness regarding consequences of electric injury. Thirty one percent had medium level of awareness and only 14 % had high level of awareness. There was a significant correlation between education level and awareness in adult patients (p<0.001). Seventy percent of persons with occupational injuries used only footwear and no other protective equipment.

CONCLUSION

Increasing public awareness, safety measures at workplaces are measures that will help reducing electrical burns which reduce limb and life loss.

摘要

简介

电烧伤是毁灭性的，不仅导致生命丧失，还导致肢体丧失等严重残疾。城市化、工业化和人口过剩的增加导致电伤的增加。

材料和方法

该研究是前瞻性的，评估电烧伤，并研究 18 个月（2016 年 10 月至 2018 年 3 月）期间的肢体丧失模式。记录的参数包括人口统计学数据、关于电损伤的临床数据、并发症和结果。

结果

男性患者占 85.3%。平均 TBSA 为 24.76 ± 19.18%。平均年龄为 27.59 ± 13.73 岁。儿科患者占 17%。高压烧伤占 68.2%。电接触烧伤是最常见的类型，占 49.5%的病例。最常见的原因是职业性（38.9%）。22%的患者需要筋膜切开术，截肢率为 38%（550 例中有 209 例）。有 190 例大截肢和 106 例小截肢。总体而言，右上臂截肢是左臂截肢的两倍。上肢：下肢截肢的比例为 4:1。50 名患者（23.9%）需要进行修正截肢。11 至 30 岁年龄组占截肢患者的 55.5%。男性（31.31%）和女性（41.97%）的截肢率无统计学差异。TBSA 小于 25%的患者截肢率为 47.77%，TBSA 大于 25%的患者截肢率为 19.47%（p<0.001）。大多数截肢是由于电接触烧伤（74.16%）。在高压组中，46.1%的患者接受了截肢手术，而在低压组中，这一比例为 20.6%（p<0.001）。总死亡率为 12.7%。300 名患者（55%）对电伤的后果缺乏认识，其中 31%有中等程度的认识，只有 14%有高度的认识。在成年患者中，教育水平与意识之间存在显著相关性（p<0.001）。70%的职业伤害患者仅使用鞋类，而不使用其他防护设备。