Multidisciplinary approach for a severe head burn caused by high-voltage electrical shock - a case report
DOI:
https://doi.org/10.12775/JEHS.2022.12.09.089Keywords
burn, reconstructive neurosurgery, reconstruction of skull bones defects, head injury, cranioplastyAbstract
In modern reconstructive medicine, personalized bone substitutes provide therapeutic hope for patients with non-standard bone defects. The study aims to present a description of a case of using a personalized bone substitute material, taking into account the vascular connections formed after a previous skin transplant.
The 29-year-old patient was admitted to the plastic surgery department urgently after being electrocuted with high voltage. Due to extensive scalp burns, a skin graft was performed in the area of previously removed skin along with a charred skull bone vault.
After a few months, the patient was qualified for cranioplasty with the use of personalized bone substitutes. The necessity to make cuts around the vascular connections present in the transplanted tissue was the main difficulty in the for the operator.
The operation was successful and the recovery was uneventful. The patient was discharged home in good general and local condition.
The presented case illustrates the need to take into account creating vascular connections with the use of personalized bone substitutes in patients after skin transplants.
References
Batista Napotnik, T., Polajžer, T. & Miklavčič, D. Cell death due to electroporation - A review. Bioelectrochemistry 141, (2021).
Lee, D. H., Desai, M. J. & Gauger, E. M. Electrical Injuries of the Hand and Upper Extremity. Journal of the American Academy of Orthopaedic Surgeons 27, E1–E8 (2019).
Shih, J. G., Shahrokhi, S. & Jeschke, M. G. Review of Adult Electrical Burn Injury Outcomes Worldwide: An Analysis of Low-Voltage vs High-Voltage Electrical Injury. J Burn Care Res 38, e293–e298 (2017).
Gandhi, G., Parashar, A. & Sharma, R. K. Epidemiology of electrical burns and its impact on quality of life - the developing world scenario. World J Crit Care Med 11, 58 (2022).
Chang, K. P. et al. Free flap options for reconstruction of complicated scalp and calvarial defects: Report of a series of cases and literature review. Microsurgery 30, 13–18 (2010).
Cho, J. Y. et al. One Stage Reconstruction of Skull Exposed by Burn Injury Using a Tissue Expansion Technique. Arch Plast Surg 39, 118 (2012).
Yoon, T. & Kim, S. W. Scalp Reconstruction and Cranioplasty using the Latissimus Dorsi Musculocutaneous Flap in a Patient with Recurrent Wound Dehiscence Accompanied by MRSA Infection. Korean Society for Head and Neck Oncology 38, 59–63 (2022).
Hierner, R., Loon, J. van, Goffin, J. & Calenbergh, F. van. Free latissimus dorsi flap transfer for subtotal scalp and cranium defect reconstruction: Report of 7 cases. Microsurgery 27, 425–428 (2007).
Coruh, A. High Voltage Electric Burn Repair of the Forehead by Reverse Flow Temporalis Muscle Flap. J Burn Care Res 40, 373–376 (2019).
Jadhav, C. N. & Sharma, R. K. Bipedicled scalp flaps for reconstruction of high-tension electric burns of calvarium. J Craniofac Surg 25, e406–e408 (2014).
Bell, A., Christoduolides, N., Ibrahim, S. & O’Sullivan, J. B. The danger of DIY Do-It-Yourself related full thickness burn injury: Case report during COVID-19 lockdown in Ireland. Burns Open 6, 146–151 (2022).
Dahmardehei, M., Rezaiyan, M. K., Safarnejad, F. & Ahmadabadi, A. An unprecedented increase in burn injuries due to alcohol-based hand sanitizers during the COVID-19 outbreak. Med J Islam Repub Iran 35, 1–4 (2021).
Bounds, E. J., Khan, M. & Kok, S. J. Electrical Burns. StatPearls (2022).
Kolbenschlag, J. et al. Transplantation of a latissimus dorsi flap after nearly 6 hr of extracorporal perfusion: A case report. Microsurgery 41, 75–78 (2021).
Bhatti, D. S., Chowdhury, R., Ang, K. K. & Greenhowe, J. Paediatric Burns of the Hand: Our Experience Over Three Years. Cureus 13, (2021).
Aba, L. et al. Gyermekkori, áramégés okozta kézujjsérülések ellátásáról és késői szövődményeiről. Orv Hetil 163, 564–568 (2022).
Roehl, K., Geoghegan, J., Herndon, D. N., Patterson, J. & McCauley, R. L. Management of class IV skull burns using the bipedicled superficial temporal artery scalp flap. J Craniofac Surg 19, 970–975 (2008).
Li, X. Q. et al. [Effects of anteriolateral thigh perforator flap and fascia lata transplantation in combination with computed tomography angiography on repair of electrical burn wounds of head with skull exposure and necrosis]. Zhonghua Shao Shang Za Zhi 34, 283–287 (2018).
Zhang, W., Xie, W. G., Yang, F., Zhang, W. D. & Chen, L. [Clinical application of lobulated transplantation of free anterolateral thigh perforator flap in the treatment of electric burns of limbs]. Zhonghua Shao Shang Za Zhi 35, 790–797 (2019).
Sarygin, P. v., Popov, S. v. & Ukhin, S. A. [Surgical treatment of post-burn defects of face and calvaria]. Khirurgiia (Sofiia) 17–22 (2020) doi:10.17116/HIRURGIA202008117.
Chudasama, S. et al. Does voltage predict return to work and neuropsychiatric sequelae following electrical burn injury? Ann Plast Surg 64, 522–525 (2010).
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Copyright (c) 2022 Zofia Hoffman, Piotr Homa, Jakub Krzysztof Gałązka, Leon Sakwa, Michał Szymoniuk, Łukasz Domagalski, Marcin Wdowiak, Wojciech Czyżewski, Radosław Rola, Sergey Antonov
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