Abstract
In cases of electrical injury, the Joules of heat produced in the body cause extensive thermal exposure-induced damage followed by progressive necrosis. We report the treatment challenges in a patient with electrical injury and subsequent progressive necrosis of the lower back. A 37-year-old man was hospitalized for electrical injuries sustained during occupational exposure to a 66,000-V electrical cable that came into contact with a cutter in his left chest-pocket. Third-degree burns covered 8% of the body surface area, with the severe area of the waist back accounting for 5%. On Day 14 of hospitalization, debridement and skin grafting were performed for the ulcers, but no graft take was observed. Progressive necrosis over the markedly damaged lower back was evident. On Day 28, the border of the necrotic and normal areas around the waist was visualized on contrast CT. There was judged to be no progressive necrosis in this area. On Day 35, a reverse latissimus dorsi muscle flap was applied. Identification of progressively necrotic tissue and areas with good vascularity is important in the treatment of electrical injuries. Wounds caused by electrical injury with progressive necrosis require daily observation and evaluation through imaging.
