Four Limb Amputations: A Tragic End of Electrical Burn

Electrical burns are still a common hazard for developing and modern societies, despite an increased awareness of their potential dangers. Electrical injuries are particularly dangerous, as they can be instantaneously fatal and also put rescuers in significant danger. An electrical burn potentially has three different components: (1) the true electrical injury from current flow, (2) an arc or flash flame injury produced by current arcing at a temperature of approximately 4000°C from its source to ground, and (3) a flame injury from the ignition of clothing or surroundings. References in the literature refer to limb amputation after burns usually occurring after high voltage electrical or major burns,1,–3 secondary to extensive soft tissue destruction,4,5 or circumferential limb burns that compromise the circulation of the affected limb.6 In this article, we want to present a very rare and tragic complication of electrical burn7: four limb amputations. Our patient was an 18-year-old man who was brought to our burn centre because of electrical injury due to contact with a high voltage (20,000 v) electric cable during working. On arrival, the extent of burn was about 11% of total body surface area involving four extremities and also arcing phenomenon was visible on his chest. Although relatively small body surface area was involved, unfortunately, patient soon developed edema of four extremities for him escharotomy and fasciotomy performed in the first day that unfortunately he did not respond to these procedures and necrosis of four extremities gradually developed, so that, left arm amputation, left above knee amputation, right forearm amputation, and right below knee amputation were done on days 6, 8, 16, and 22, respectively.