A man severely burned by high-voltage electricity in Laos survived after staged debridement and flap and graft repair, and now stands with walking aids

Care team

Director Xie Julin of the Department of Burns & Wound Repair led the team, and Professor Zhu Jiayuan guided the treatment. Chief Physician Hu Zhicheng led the debridement operations, and Dr Cao Xiaoling also treated the patient. Head Nurse Xie Xiaoxia led the nursing team.

The patient

A man working in Laos was electrocuted by a 380-volt line while working at height. He had deep, mostly third-degree burns over about 18% of his body, on the left arm, chest, both shoulders and back, the right leg and foot, and the right ear.

Why it was difficult

He waited two days for transfer. By admission, dead tissue under the burns was spreading, his left arm and right foot were at risk of tissue death, and his infection, kidney and clotting results were at critical levels.

What the team did

The burns ICU supported his breathing and circulation, treated the infection and managed his nutrition. Over about a month, the team operated in stages: they cut into the burned skin to relieve pressure in the swollen limbs, repeatedly removed dead muscle and vessels, covered the wounds temporarily with xenografts and used negative-pressure wound therapy. Once he was stable, the team closed the wounds with a pedicled axial flap and autologous skin grafts combined with an epidermal cell suspension. The hospital says it has published this technique in the British Journal of Surgery.

Outcome

The infection came under control and his kidney function recovered. After rehabilitation he could stand and was trying to walk with walking aids.