AKUT ELEKTRÝK YANIKLARI: 6 YILLIK DENEYÝMLERÝMÝZ

Ýstanbul Týp Fakültesi Acil Cerrahi Biriminde son 6 yýl içinde (1989-1995) 101 elektrik yanýðý olgusu tedavi edildi. Bu dönem içinde %10.2'sini elektrik yanýklarýnýn oluþturduðu toplam 985 yanýk hastasý ünitemize kabul edilmiþtir. Düþük voltajlý elektrik yanýklarý 59 (%58.5) vakada görülmüþtür. Bunlarýn çoðu önlenebilir ev kazalarý olup, çocuk ve kadýnlarda görülmüþtür. Bu tip elektrik yanýklarýnda, ayný diðer yanýklardaki cerrahi prensipler geçerlidir. Serimizdeki yüksek voltaj yaralanmalarýnýn insidensi %41.5'dir Bunlar ise genellikle ev dýþý olaylarda ve genç eriþkin erkeklerde görülmüþtür. Amputasyonlar 22 (%52) hasta ile en büyük komplikasyon grubunu uçurmuþlardýr. %76'sý üst, %24'ü ise alt ekstremitelerde uygulanmýþtýr. Mortalite oraný %11.8 (12 vaka ), ortalama hastanede kalýþ süresi ise 25 gündür. 42 vakadan 11'i ünitemize ilk 24 saatten sonra, bunlarýn 7'si de 5.günleri içinde gelmiþlerdir. Biz bu yüksek amputasyon ve mortalite oranýmýzý hastalarýn ünitemize geç geliþlerine baðlýyoruz. Bu gecikme erken-yoðun sývý replasmanýný, sürekli hemodinamik-metabolik destek saðlanmasýný ve erken agresiv cerrahi giriþimde bulunmamýzý engellemektedir.

ACUTE ELECTRICAL BURNS: 6 YEAR EXPERIENCE

We have reviewed 101 cases of electrical burns treated at the Emergency Medical School of Istanbul Medical Faculty during the past 6 years (1989-1995). There were 985 acute burns admissions during this period, the incidence of electrical burns being 10.2 percent. Low-voltage electrical burns occured in 59 of the 101 patients (58.5 percent). These were caused mostly by household electricity suplies, occured in children, and were preventable. The surgical management of these burns was similar to other thermal burn injuries. The incidence of high-voltage elected injuries 41.5percent in our series. These tended to occur outside the home in young adult males and were also frequently preventable. Amputations constituted the single largest category of complications. Being neccessary in 22(52 percent). Seventy-six percent of the amputations were in the upper extremity, while twenty-four percent in the lower. The overall mortality rate was 11.8 percent (12 cases) and the mean hospital stay was 25 days. We attribute these high amputation and mortality rates in our series to late transfer of patients to our Burn Unit. 11 of the 42 patients were transferred to our unit after their 1st day and seven of them were in their 5th day. This delay prevented us from providing an aggresive fluid resuscitation, continuous haemodynamic and metabolic support, and early agressive surgical intervention.