The Evaluation of a Golden Period of Fasciotomy for High Voltage Electrical Burn Injury Patients With Compartment Syndrome.

Abstract

Electrical burn injuries can cause various acute manifestations that require surgeons to make an early decision, such as fasciotomy for compartment syndromes. Early decompression can become a 'golden period'for limb salvation. This study evaluates the duration of burn to fasciotomy (B-F time) and amputation. A cross-sectional study was performed on medical records. Inclusion criteria were patients with high voltage electrical injuries and compartment syndrome. Exclusion criteria were patients whose extremities were already non-vital on admission and those lost to follow up. Demographic information, burn surface area and B-F time for patients amputated above the elbow (group A amputation), below the elbow (group B amputation), and no amputation (non-amputated) were investigated. More than 50% patients underwent amputation and 60% had less than 18 hours B-F time. Mean B-F time for non-amputated patients was 18 hours and for amputated patients 20.38 hours. Mean burn to amputation (B-A) time and fasciotomy to amputation (F-A) time in group B was about double compared to group A. The B-A time range of group Awas 4.2-7.3 days. Our study showed 18 hours maximum to be the golden period of burn to fasciotomy. The window period of muscle injury evaluation is maximum 7 days to permit limb salvation at the lowest level possible.