Quinby W C, Burke J F, Trelstad R L, Caulfield J
J Trauma. 1978 Jun;18(6):423-31. doi: 10.1097/00005373-197806000-00007.
High-tension electrical burns sustained by 44 patients were of two types: one is caused by the intense heat of contact with an electric arc, and in the other flow of current against resistance of the deep tissues between arc wounds of entrance and exit produces deep thermal destruction. Microscopic studies in nine patients support the conclusions that such high-tension burns are thermal injuries, that the tissue destruction is not uniform, and that the slow evolution of unexcised wound reflects the admixture of areas of varying tissue viability which may become infected. An aggressive surgical approach designed to minimize tissue loss, avoid infection, and close wounds as early as possible was guided by intraoperative and later microscopic determinations of tissue viability. Despite a high amputation rate in our patients, it was avoided in the upper extremity in three patients, and maximal length of extremities was preserved in seven others. The use of microscopic analysis is recommended to determine the viability of tissues in thermal burns.
44例患者遭受的高压电烧伤有两种类型：一种是因与电弧接触产生的高热所致，另一种是电流通过进出电弧伤口之间深部组织的电阻时产生深部热损伤。对9例患者的显微镜研究支持以下结论：此类高压烧伤属于热损伤，组织破坏并不均匀，未切除伤口的缓慢演变反映了不同组织活力区域的混合，这些区域可能会发生感染。旨在尽量减少组织损失、避免感染并尽早闭合伤口的积极手术方法，是根据术中及术后对组织活力的显微镜测定来指导的。尽管我们的患者截肢率很高，但3例上肢患者避免了截肢，另外7例患者保留了肢体的最大长度。建议使用显微镜分析来确定热烧伤中组织的活力。
