The treatment of electrical injury compared to burn injury: a review of pathophysiology and comparison of patient management protocols.

Because of basic differences in pathophysiology, patients with electrical injury require therapeutic measures quite separate and distinct from patients with flame burns. Fluid requirements are much greater for the electrical-injured patient due to the depth of the injury and frequent occurrence of pigment in the urine. Fasciotomy with surgical exploration for determination of tissue viability is usually required in areas of obvious or questionable viability in patients with electrical injury. Sulfamylon is preferred for topical antibacterial therapy in electrical injury, because of its excellent penetration into deeper tissues. With this regimen of conservative surgical debridement of necrotic tissue, in many patients we have been able to salvage limbs and, in particular, preserve function.