High Voltage Electrical Burn Injury of the Upper Extremity: A Prospective Observational Study from Bangladesh

Introduction. Electrical burn injury is one of the most disastrous forms of burn trauma involving the upper extremity. It may lead to devastating complications, including limb loss and even death. This study aimed to characterise the epidemiology of high-voltage electrical burn injury (HVEB), which is critical for developing prevention strategies and evidence-based management guidelines to address this serious public health issue. Methods. This prospective observational study was conducted at the National Institute of Burn and Plastic Surgery (NIBPS), Dhaka, Bangladesh, between January 1, 2022, and June 30, 2022. Based on specific inclusion and exclusion criteria, a total of 112 patients with high voltage electric burn injury involving upper limb were included in the study from total 521 patients with high-voltage electrical burn injuries attended the emergency within this period. Data were collected through a structured data sheet and analysed. Results. A significant male predominance was observed (89.3%), and more than 70% of patients were aged 13-40 years. Ninety-three per cent (93%) of patients came from urban areas. Approximately 56% of accidents occurred while working in unsafe environments without safety protocols, and it was alarming that only 7% of workers used proper protective equipment. Women (2.7%) were primarily affected while drying clothes on rooftops or balconies. Bilateral limb involvement was present in 52% of cases. Seven per cent (7%) of patients presented with charred limbs. The right upper limb was the entry point in 67% of cases. Impending compartment syndrome was evident clinically in 45.5% of patients, necessitating fasciotomy. Finally, 40% of patients underwent limb amputation at different levels within 7-10 post-burn days. Discussion and Conclusions. Electrical burn injury remains a major health problem in developing countries. Most injuries are occupation-related and affect young active males. However, electrical burn injuries are largely preventable. Measures should be taken to create awareness among the population to prevent these devastating injuries.