Fujii T
Department of Plastic and Reconstructive Surgery, Nagasaki School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1998 Jan;99(1):52-6.
Electrical injury can be classified into true electrical injury, are burn. In true electrical injury, large or small, dry, dark brown necrotic wounds (electric current spots) are observed on the skin at the entrance and exit sites of the electric current, and progressive necrosis develops in surrounding tissues. As generalized symptoms, ventricular fibrillation, respiratory arrest, and loss of consciousness may be observed temporarily immediately after the injury. Necrosis also occurs in deep tissues including muscles, and pathology resembling crush injury is seen. Myoglobin released into the circulation due to muscle necrosis tissue causes myoglobinuria and increases the risk of acute renal failure. Treatment consists of emergency resuscitation and fluid supplementation with lactated Ringer's solution. However, more fluid should be administered than in cases of common burns to accelerate urinary excretion of myoglobin in the circulation. For local treatment, debridement should be performed in areas with clear third-degree burns, but in the presence of progressive necrosis, repair and reconstruction after debridement should be postponed for 2-3 weeks.
电击伤可分为真性电击伤、电弧烧伤。在真性电击伤中，在电流的入口和出口部位的皮肤上可观察到大小不一、干燥、深褐色的坏死伤口（电流斑），周围组织会发生进行性坏死。作为全身性症状，受伤后可立即暂时观察到心室颤动、呼吸骤停和意识丧失。包括肌肉在内的深部组织也会发生坏死，可见类似挤压伤的病理表现。由于肌肉坏死组织释放到循环中的肌红蛋白会导致肌红蛋白尿，并增加急性肾衰竭的风险。治疗包括紧急复苏和用乳酸林格氏液补充液体。然而，与普通烧伤相比，应给予更多的液体以加速循环中肌红蛋白的尿排泄。对于局部治疗，在明确为三度烧伤的部位应进行清创，但如果存在进行性坏死，清创后的修复和重建应推迟2至3周。
