Clinical Challenges in Burn Surgery: Electrical Burns - Part 2 of 2

High-voltage electrical injuries necessitate immediate clinical assessment for compartment syndrome, as objective pressure measurements often delay critical surgical intervention. Diagnosis relies on the classic five P's and physical examination rather than mechanical devices like Stryker probes, which are considered unnecessary and potentially counterproductive in high-voltage cases. Surgical management requires comprehensive fasciotomy of the forearm and hand, including mandatory carpal tunnel release, followed by staged debridement and wound coverage. Long-term recovery involves addressing complex sequelae such as Volkmann’s ischemic contracture, neuropathic pain, and potential heterotopic ossification. Reconstruction strategies, including tendon transfers or free-functioning muscle transfers, must be tailored to the specific tissue loss identified during initial exploration. Establishing baseline ophthalmologic exams is also recommended to monitor for late-onset cataracts, while vocational counseling supports the reintegration of injured patients into the workforce.