The Iceberg Phenomena
AbstractIntroduction: The deceptive nature of electrical injury is likened to an iceberg phenomena. Whether the tissue is conductive or resistant both are injured due to electroporation and heat, respectively. The objective of the study is to evaluate the types and pattern of injuries and attempt to predict the chances of various types of injuries and highlight the iceberg phenomena.
Methods: A retrospective study includes 36 patients. Injuries were classified into superficial and deep. Total burned surface area (TBSA) was categorized into four, </= 5%, 6 to 10%, 11 to 20%, and > 20%. The depth of injury was categorized into superficial and deep. Deep injuries were elaborated into loss of skin, muscle, tendon, nerve, artery, cartilage and damage of bone and internal organs. Treatment was grouped into conservative and surgical, where surgical was classified into minor, major and amputation procedures.
Results: Injuries were mostly located over the upper extremities (47.76%). The first TBSA category had the highest number of patients (64%), highest percent of superficial and deep injuries (63.88% and 61.29%, respectively) and highest percentage of procedures (64.25%). The average number of procedures per patient was 3.8. The median burned surface area (BSA) was 4% and most of the procedures were performed in patients with less than 4% BSA.
Conclusion: Electrical injuries are truly iceberg phenomenon where a small area of TBSA hides the greatest percentage of the deep structure injuries and brings about surprising reconstructive challenges.
Key: electrical injury; nerve, arterial, tendon injuries; skin loss; amputations; debridements; skin grafting; reconstructive flaps.
Copyright and Open Access Policy
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
JSSN applies the Creative Commons Attribution (CC BY) license to all works we publish. Under the CC BY license, authors retain ownership of the copyright for their article, but authors allow anyone to download, reuse, reprint, distribute, and/or copy articles in JSSN, so long as the original authors and source are cited. No permission is required from the authors or the publishers.
Article by JSSN is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at http://www.jssn.org.np/index.php?journal=jssn.