Acute electric burns. Current diagnostic and therapeutic approaches to management.

A review of 102 cases of high-voltage electric injuries was performed. The average total body surface area was 15.2%. The average age was 32 years. The mortality was 2.1%. Advances in fluid therapy have virtually eliminated renal failure. Devitalized muscle was accurately identified preoperatively with the use of the technetium Tc 99m pyrophosphate muscle scan. Septic complications were reduced substantially by using the following therapeutic modalities: early excision of the burn eschar and necrotic muscle; quantitative wound biopsies to monitor the bacterial flora; allograft as a temporary coverage of open wounds; and early creation of local and distant flaps. Early institution of physical and occupational therapy are mandatory if the patient is to be restored to his or her maximum postinjury potential.