Frequency and Outcome of Spontaneous Hemorrhage in Electrical Burn Injuries at Burns Centre, Karachi

Objective: To determine the frequency of spontaneous hemorrhage and its effect on mortality rate among electric burn injury patients. Materials and Methods: It is a retrospective review of the consecutive patients with electric injuries who were managed at Burn Centre, Karachi over a 4 year period spanning from January 2008- December 2011. Data were extracted regarding age of patient; site involved in electric burn, artery involved in spontaneous hemorrhage, surgical intervention, recurrence of hemorrhage and associated mortality. Results: Electric burn constituted 1.42% of admissions in our burn Centre (n=208). Frequency of spontaneous hemorrhage was found in 25% (n=52) of cases. Frequent site of injury involved in spontaneous hemorrhage was upper limbs (44.25%), followed by lower limbs and anterior trunk. Most common vessel involved in spontaneous hemorrhage was axillary artery (19.23%, n=10) followed by radial artery (11.53%, n=6) and popliteal artery (11.53%, n=6). Surgical procedures carried out were primary ligation and amputation. Bleeding recurred in 23.07% of cases. Total mortality in electric burns cases was 13.46 % (n=28/208), however out of these 28 cases, mortality rate due to spontaneous hemorrhage was 32.14% (n=9/28). Conclusion: Prompt and timely institution of appropriate surgical interventions among electric burn injury patients has the potential to reduce the frequency of life-threatening episodes of spontaneous hemorrhage and improve the outcome in terms of morbidity and survival.