The Role of Early Fasciotomy in the Treatment of Electric Burn Induced Peripheral Nerve Injury

早期肌膜切開術在電燒傷導致週邊神經傷害角色的動物研究

吳思賢(Szu-Hsien Wu) ； 陳子瑾(Tzyy-Jiin Chen) ； 馬旭(Hsu Ma) ； 黃生旺(Seng-Wong Huang) ； 蕭明亮(Ming-Liang Hsiao) ； 方榮煌(Rong-Hwang Fang)

《中華民國整形外科醫學會雜誌》 15卷4期 (2006/12) Pp. 322-329

https://doi.org/10.7096/JPSA.200612.0322

摘要

According to the statistical study done by the Childhood Burn Foundation of the Republic of China, about 5% of the burn injuries in Taiwan were induced by electrical insults. Despite the tissue destruction, neurological symptoms and signs are quite common following electrical injury and often serve as the cause for a patient's failure to return to work. Therefore, further research of the efficiency of treatment modality of the injured peripheral nerves due to electrical insults is an important issue. For example, is it feasible to perform immediate fasciotomy routinely? With the modified Buchanan's rat model, we designed a prospective animal study to evaluate the feasibility of the routine fasciotomy immediately after electrical insults. Electrical insults followed with/without fasciotomy were carried out and NCV/EMG studies were done. The terminal motor latency and compound motor action potential were calculated for statistic analysis. In this series, we found that both the axonal and myelinic damages of the sciatic nerves were less severe in the fasciotomy group with statistical significance. However, inflammatory cell infiltration, red cell accumulation and thrombosis were found in the histology study in both groups. In conclusion, we suggest the consideration of fasciotomy following electrical injury as one of the important treatment options because nerve decompression is a common practice with low surgical risk, and this simple procedure might provide benefits to improve the outcome.

並列摘要

According to the statistical study done by the Childhood Burn Foundation of the Republic of China, about 5% of the burn injuries in Taiwan were induced by electrical insults. Despite the tissue destruction, neurological symptoms and signs are quite common following electrical injury and often serve as the cause for a patient's failure to return to work. Therefore, further research of the efficiency of treatment modality of the injured peripheral nerves due to electrical insults is an important issue. For example, is it feasible to perform immediate fasciotomy routinely? With the modified Buchanan's rat model, we designed a prospective animal study to evaluate the feasibility of the routine fasciotomy immediately after electrical insults. Electrical insults followed with/without fasciotomy were carried out and NCV/EMG studies were done. The terminal motor latency and compound motor action potential were calculated for statistic analysis. In this series, we found that both the axonal and myelinic damages of the sciatic nerves were less severe in the fasciotomy group with statistical significance. However, inflammatory cell infiltration, red cell accumulation and thrombosis were found in the histology study in both groups. In conclusion, we suggest the consideration of fasciotomy following electrical injury as one of the important treatment options because nerve decompression is a common practice with low surgical risk, and this simple procedure might provide benefits to improve the outcome.

並列關鍵字

Electric burn injury ； nerve injury ； fasciotomy