Evisceration due to full thickness injury to the abdominal wall, with intestinal involvement, plus trauma to the chest wall, extremities and genitals due to high voltage electrical burn; case report and review of the literature

José Vicente Fonseca Barragán, Lorena Katiuska Toscano Ortiz, Gabriel Alexander Minda Mina, Pablo Bruno Minda Espín, Patricio Alberto Castillo Peñaherrera, David Israel Rea Chauca, Angie Milena Valdez Bautista, Mirtha Marisol Bautista Arana, Yurvis Marilyn Blanco Martínez, Dionis Carolina Cariel Reyes, Patricia Jordana Valdivieso Estupiñán
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Abstract

Electrical burns are one of the most drastic traumas to which an individual can be exposed; being able to directly or indirectly compromise almost all tissues of the human body. They cause more than 3,000 admissions to specialized burn units in the United States. Up to 40% of serious electrical injuries are fatal, resulting in approximately 1000 deaths per year.Its incidence depends on the type of exposure to electricity: low voltage, due to contact with electrical cables or plugs. High voltage, due to occupational exposures and power lines while climbing trees or poles. These voltages are more likely to cause injuries to deep tissues and internal organs compared to low voltage injuries and also the degree of body surface area burned.Its approach constitutes a challenge, since the risks of visceral involvement are added to the morbidity and mortality inherent to the burn. Early treatment of intra-abdominal complications allows a more conservative approach, reducing ostomies and their associated comorbidity. It is preferable to manage the abdominal defect by preserving the tissues themselves and restoring the midline. In our case, it was feasible to perform a primary closure of the abdominal wall. Your treatment will depend on factors such as: the amount of tissue lost, intra-abdominal contamination, general condition, and factors such as: physical resources and experience of the hospital. Mortality from burns ranges between 3 and 55%, those with the highest risk of death are those at extreme ages, higher degrees of burns, injuries associated with inhalation, and injuries in patients with comorbidities.
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高压电烧伤导致腹壁全层损伤并累及肠道,加上胸壁、四肢和生殖器外伤引起的开裂;病例报告和文献综述
电烧伤是个人可能遭受的最严重的创伤之一,能够直接或间接损害人体的几乎所有组织。在美国,烧伤专科病房收治的烧伤患者超过 3000 人。多达 40% 的严重电伤是致命的,每年造成约 1000 人死亡。电伤的发生率取决于接触电的类型:低电压,由于接触电缆或插头。高压,由于职业暴露和爬树或爬电线杆时接触电线。与低电压伤害相比,这些电压更容易造成深层组织和内脏器官的伤害,而且烧伤的体表面积也更大。由于内脏受累的风险是烧伤固有的发病率和死亡率的补充,因此其治疗方法是一项挑战。早期治疗腹腔内并发症可以采取更保守的方法,减少造口及其相关并发症。最好是通过保留组织本身和恢复中线来处理腹部缺损。在我们的病例中,对腹壁进行初次闭合是可行的。治疗方法将取决于以下因素:损失的组织量、腹腔内污染、全身状况以及医院的物质资源和经验。烧伤的死亡率在 3% 到 55% 之间,死亡风险最高的是那些年龄偏大、烧伤程度较高、与吸入有关的损伤以及有合并症的患者。
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