Yuan Z.Q., Peng Y.Z.

Institute of Burn Research, Southwest Hospital, Third Military Medical University, Chongqing, People’s Republic of China

SUMMARY. Fishing rods are made of non-insulated graphite and carbon, which are highly conductive to electricity. This causes a potential hazard of electrical injury to fishermen. Eight cases of persons suffering from electrical injuries caused by their highly conductive fishing rods touching overhead electric cables are reported. The clinical characteristic of such injuries and suggestions for prevention are discussed.

Introduction

Electrical injuries are still a common hazard in modern society, despite increased awareness of their potential dangers. Although electrical burns constitute approximately only 3% of admissions to major burn units, their high amputation and mortality rates give great cause for concern.1 Every year many electrical injuries occur outside the home as a result of contact with overhead high-voltage lines or underground cables. We report eight cases of persons who suffered electrical injuries due to contact with overhead high-voltage lines while fishing with graphite rods. The mechanisms of such injuries, their treatment, and suggestions for prevention are discussed.

Patients and methods

A retrospective analysis was made of eight patients admitted to the burns unit at Southwest Hospital (Chongqing, China) between 1996 and 2001 who had sustained electrical burns caused by touching, or proximity to, overhead electric cables while fishing with graphite rods. The information obtained from patient records included age, sex, burn mechanism and severity, associated lesions, urine myoglobin, continuous cardiac monitorization, serum creatinine phosphokinase, operative procedures for wound management, length of hospital stay, and complications.

Results

All eight patients admitted during the period of investigation were male. Their ages ranged between 28 and 66 yr, with an average of 43.3 yr (Table I).

At the scene of the accident, three of the eight patients had initial loss of consciousness and one suffered cardiac arrest. The average burned body surface area (BSA) was 21.5% (range, 1-62%). All the patients had full-thickness skin burns in an average total BSA of 9.25%, ranging from 1 to 35%. The regions most commonly affected by electrical injuries were the upper and lower limbs. The upper limbs were the most commonly involved as the pathway of entrance and exit areas.

Excision and grafting were carried out in all eight patients, and one patient required amputation. Tracheotomy was performed in two patients. Myoglobinuria occurred in two patients, though none developed renal failure. One patient died owing to sepsis on day 44 post-burn. Among the survivors the average hospital stay was 46 days (Table II).

Discussion

With the improvement of our standard of living, interest in fishing has increased. This paper describes a special type of electrical burn injury caused by contact between a graphite fishing rod and overhead electric cables.

At present, most fishing rods are made of non-insulated graphite and carbon, which are highly conductive to electricity. This constitutes a potential hazard of electrical injury to fishermen.2,3 The resistance of all-carbon graphite fishing rods with a carbon content more of than 70% is very low. When closely approached, the uninsulated cables of an overhead line discharge an electric current that can jump a gap of 30 cm or more. The voltage carried by these lines varies from 220 to 400,000 V, and any contact can be fatal.

The eight cases reported in this paper presented some similar features. There were obvious entry and exit wounds. All the patients had severe injuries in the palm of the hands, plus dysfunctions of the fingers. Most of the patients had small burn areas, but three suffered burn injuries in more than 50% total BSA. This is explained by the mechanism of such injuries: the victims sustain a flash burn as a result of the arc, and clothing may be ignited. These flash burns are thermal burns of mixed full and partial thickness. After admission, great attention was paid to fluid resuscitation, renal function, and regular limb neurovascular observation. When the warning signs of arterial thrombosis and compartment syndrome were seen, operations including escharotomy or fasciotomy were necessary.

Wound management after high-tension electrical injury has given rise to considerable controversy in the past.4 There are divergent opinions about the correct therapeutic approach to wound management. All the patients in this report underwent surgical procedures. There were severe injuries to the hands, and first-stage repair using a skin flap or a myocutaneous flap after early debridement was therefore our treatment of choice. Most of the patients achieved good aesthetic results in the wound area, plus satisfactory self-care and ability to work. Thorough early debridement of necrotic tissue, careful preservation of living tissue, an appropriate choice of tissue flap, and post-operative rehabilitation training were of great importance to achieve a good prognosis.

Conclusion

This special experience should make us aware that the prevention of such electrical burns is as important as their correct management. Fishing rod manufacturers should advertise the dangers of this electrical conductor by applying warning stickers to the rod. We would recommend that prominently displayed warning notices should be put up at popular fishing spots where electric power lines are close by. If such steps are taken to increase public awareness of the potential hazards, the morbidity due to these injuries should be considerably reduced.

RESUME. Les cannes à pêche sont fabriquées en utilisant la graphite et le carbone non isolé, qui sont de bons conducteurs de l’électricité, ce qui constitue un risque potentiel de lésions électriques pour les pêcheurs à la ligne. Les Auteurs, après avoir présenté huit cas de pêcheurs atteints de brûlures électriques quand leur cannes hautement conductrices sont entrées en contact avec des câbles électriques aériens, décrivent les caractéristiques cliniques de ce type de lésion et proposent des méthodes pour la prévention

Bibliography

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2. Clarke A.M., Moss A.L.H.: Severe electrical injury from a graphite fishing rod. Injury, 21: 120-1, 1990.
3. Logan M.A.: Electrical burns caused by fishing rod contact with overhead electric cables: A potential hazard to fishermen. Burns, 19: 535-7, 1993.
4. Baxter C.R.: Present concepts in the management of major electrical injury. Surg. Clin. North Am., 50: 1401-18, 1970.