Changing trends in pediatric upper extremity electrical burns
BACKGROUND: Upper extremity electrical burns are a cause of major morbidity and disability in affected individuals. Anecdotally, we have noted changes in the presentation of cases to our institution. We sought to compare current data on upper extremity electrical burns in children with our previously published historical data.
METHODS: Using the Shriners Hospital Boston and American Burn Association databases, we retrospectively analyzed electrical upper extremity burns in patients aged 21 years or younger. Data regarding demographics, etiology, and reconstruction were collated and analyzed.
RESULTS: In our institutional cohort, patients were most commonly males (37/48, 77%) aged 10-15 years (19/48, 40%). We have seen a rise in the proportion of female, younger patients, with burns attributed to domestic wiring, indicative of a reduction in the number of high-voltage injuries in males due to demonstrations of bravado. High-voltage injuries correlate with severity of injury and tended to be transferred to our institution from foreign countries (9/48, 19%). We have also seen a reduction in the need to amputate extremities.
CONCLUSIONS: Changes in upper extremity electrical burn demographics and etiology since the 1970s may be indicative of effective education and safety campaigns. Consequently, reconstructive requirements have also changed. We hope that similar ongoing efforts in the developing world may bring about comparable positive results.