Treatment Strategy for an Electrical Burn Patient with Multiple Fourth-Degree Wounds

Abstract

Electrical burns, especially high-voltage burns, usually cause necrosis of the subcutaneous fat, fascia, muscle, and bone. The reconstruction of electrical injuries often involves multiple surgeries. We present the case of a 56-year-old man who was injured by a high-voltage current resulting in multiple soft tissue defects on the left ankle and plantar area. The wounds on the malleolar and lateral plantar areas had burned the muscle, tendon, and bone. Because the patient had multiple wounds and unstable vessels, we took the strategy of operating in stages. The primary aim of treatment was wound healing and maintaining the support structure for mobility. Several rounds of wide debridement and negative-pressure wound therapy, followed by application of acellular dermal matrix and split-thickness skin graft were performed as part of the first stage. At the 1-year follow-up, the patient could walk independently wearing a splint to prevent foot drop. A second reconstructive surgery is possible, if necessary.