Asian Journal of Research in Surgery

Background: High-voltage electrical burns are complex injuries that may cause extensive deep-tissue damage, airway compromise, tissue necrosis, infection, and functional impairment, often disproportionate to the initial external appearance. Their management requires early assessment and coordinated multidisciplinary care, including airway management, serial debridement, wound care, nutritional support, rehabilitation, and staged reconstruction. Despite advances in burn care, extensive electrical injuries remain challenging because of progressive tissue damage and the need for multiple interventions.

Case Presentation: A 53-year-old man sustained an accidental high-voltage electrical burn involving approximately 65% of the total body surface area, affecting the face, neck, anterior chest wall, abdomen, bilateral upper limbs, forearms, and hands. He developed extensive full-thickness tissue loss, eschar formation, deep soft-tissue necrosis, and exposed forearm tendons, with significant airway concerns requiring surgical tracheostomy. His management included intensive wound assessment, serial surgical debridement, infection surveillance, nutritional rehabilitation, tracheostomy care, physiotherapy, staged reconstructive procedures, and adjunctive hyperbaric oxygen therapy. Four staged reconstructive procedures were performed, including skin grafting of facial and chin defects and reconstruction of the perioral soft tissues.

Discussion and Conclusion: This case is reported because of the extensive nature of the electrical injury and the complexity of integrating airway management, serial debridement, nutritional and rehabilitative support, staged reconstruction, and adjunctive hyperbaric oxygen therapy within a multidisciplinary treatment pathway. The case emphasises that successful management of severe electrical burns requires a systematic and individualised approach extending beyond wound closure to functional and psychosocial recovery. Readers may gain practical insights into the importance of timely multidisciplinary intervention, repeated assessment for evolving tissue injury, appropriate airway protection, staged reconstruction, and comprehensive rehabilitation in patients with extensive high-voltage electrical burns.