High-Voltage Electrical Burn Requiring Urgent Scalp Reconstruction after Developing a Brain Abscess

Eur. Burn J., 2024 · DOI: 10.3390/ebj5030027 · Published: September 3, 2024

Simple Explanation

This case report discusses the complexities of treating a patient with a high-voltage electrical burn to the scalp. The patient suffered extensive tissue damage and surprisingly developed a brain abscess. The patient's scalp was reconstructed using a free myocutaneous anterolateral thigh flap. Despite the reconstruction, the patient experienced limited functional recovery. This case highlights the importance of multidisciplinary care in managing complex burn injuries, especially when neurological complications and infections arise.

Study Duration

Not specified

Participants

A 69-year-old male

Evidence Level

Case Report

Key Findings

1
The patient developed an extradural abscess, which is a rare complication following electrical burns, requiring urgent surgical drainage and debridement.
2
MRI imaging revealed ischaemic changes in the cervical cord, contributing to the patient's quadriplegic spinal cord injury and peripheral neuropathy.
3
The use of Indocyanine Green (ICG) perfusion study helped assess calvarial perfusion intra-operatively, reducing the risk of osteomyelitis.

Research Summary

This case report details the management of a 69-year-old male with a high-voltage electrical burn to the scalp who developed an unexpected extradural abscess. The patient's treatment involved multidisciplinary collaboration, including urgent surgical drainage of the abscess, scalp reconstruction with a free flap, and management of neurological complications. The case emphasizes the challenges in surgical timing, the importance of assessing calvarial perfusion, and the impact of neurological sequelae on functional outcomes.

Practical Implications

Multidisciplinary Approach

Highlights the need for coordinated care involving plastic surgery, neurosurgery, and burn specialists for complex electrical burn cases.

Early Detection of Complications

Emphasizes the importance of thorough imaging and monitoring to detect rare complications like brain abscesses in a timely manner.

Surgical Timing Considerations

Demonstrates the critical decision-making involved in balancing the need for urgent infection control with optimizing patient nutrition and wound healing before reconstruction.

Study Limitations

1
The sensitivity of MRI imaging is variable, especially if performed early but may be useful in describing the expected neurological sequelae
2
Predicting the neurological manifestations is difficult; however, the entry/exit sites may offer guidance for future risk assessment in this cohort
3
This is a single case report, which limits the generalizability of the findings.

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