A 2 year old boy presents to the emergency department with the following image after chewing on an electrical cord.

 

[center][/center]

 

 

 

[size=20px]The complication most likely to occur within the first 7-10 days is

 

A infection

 

B fibrosis

 

C bleeding

 

D salivary fistula

 

E paresthesias[/size]

Fibrosis will be my answer

B fibrosis

Bleeding after sloughing of the ischemic part

Bleeding after sloughing of the ischemic part

correct

 

Although electrical burns are uncommon in children, they still play an important role in management due to the unique nature of the burns. Electrical burns constitute approximately 2-9% of pediatric burn injuries in burn centers. The degree of electrical injury experienced by an individual can be predicted by Kouwenhoven factors, including the type of current, current strength, length of time of exposure, body resistance, and the pathway the current takes in the body, in addition to electrical field strength.

 

The image depicted shows an oral commisure burn secondary to chewing an electrical cord. This results in a deep burn to the angle of the mouth, which will slough off in 5-7 days. This exposes the labial artery that can result in a delayed hemorrhage after discharge - the caregivers must be advised of this potential issue and can pinch the artery to control bleeding, while going to the hospital. Fibrosis and contractures are known complications of such burns as well; however, they typically will take longer than 2 weeks to form. Treatment for these complications is typically splinting - which may be required as an early therapy for developing contractures, or surgical excision and scar z-plasty. Salivary fistulas are not known to occur after this injury, while paresthesias may be a long term, but not short term, complication.