technetium-tc-99m-medronate and Burns--Electric

A case of deep high energy electrical burn of the skull is presented. For assessment of bone regrowth and muscle flap viability after application of latissimus dorsi free flap, combined 99mTc MDP bone SPECT and 99mTc sestamibi muscle SPECT scintigraphy were used. Whereas 99mTc MDP bone SPECT showed absent uptake at the beginning, there was good uptake 3 months after flap application. 99mTc sestamibi SPECT revealed good uptake indicating normal perfusion of flap muscle tissue.

Topics: Adult; Bone Regeneration; Burns, Electric; Humans; Male; Radiopharmaceuticals; Scalp; Surgical Flaps; Technetium Tc 99m Medronate; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon; Treatment Outcome

To establish a rabbit model of non-thermal high voltage electrical injury, which was accompanied by progressive tissue necrosis for the further study of electrical injury.. Seventy-five New Zealand rabbits were employed, in which 45 were used for the selection of the size of electrode plate, the inflicting time, the intervals and the injury degree. Five groups of rabbits were used for the study of the model. The study was carried out by means of clinical anatomical exploration, categorization by the Index of Deep Burn Injury (IDBI) and (99)Tc(m)-MDP isotope scanning and gamma photography.. The optimal injury indices selected were as follows: the electric field strength was 17 000 volts/m, the mean current intensity was 554 mA, and the average current density was 137 mA/cm(2) for small electrode and 21 mA/cm(2) for big one, and average increase of tissue temperature was 1.73 degrees C during injury process. This excluded the possibility of thermal injury. Five models were created, i.e. mild, moderate, severe, extra severe and destructive ones. There was no obvious cutaneous necrosis. Nevertheless, there was loss of injured extremities on 5th, 7th and 12th post-injury days in the severe, extra severe and destructive groups.. Non-thermal factor was the major cause of electric injury in the model with typical clinical features.

Topics: Animals; Burns, Electric; Disease Models, Animal; Rabbits; Radionuclide Imaging; Technetium Tc 99m Medronate

In high-voltage electrical burn injuries (> 1000 V), it is difficult to identify the site and extent of non-viable deep tissue damage for debridement to avoid further tissue injury from wound infection and the risk of sepsis. This prospective study was designed to evaluate the usefulness of 99Tcm-methylene di-phosphonate (99Tcm-MDP) scintigraphy in detecting the extent of tissue injury and determining the level of amputation required for electrical burn patients. Over a 5 year period, 33 high-voltage electrical burn patients were studied. Blood flow and blood pool studies revealed absent perfusion in 37 limbs, all of which eventually were amputated. In addition to a routine three-phase bone scan, images were obtained at 30-60 min (early images) to evaluate whether soft tissue injury could be detected better at that time. For comparison of the detection rate from the early images and bone (delayed) images, 164 corresponding spot views of both images were reviewed. Eighty-three and 125 tissue necrotic lesions were demonstrated by the early images and bone images respectively. All of the 83 lesions found by the early images were more clearly identified by the bone images. All but one of the 125 lesions underwent surgical debridement or amputation. We concluded that the blood flow and blood pool images correlated well with the level of amputation required. The site and extent of tissue necrotic lesions can be clearly identified on 99Tcm-MDP bone scans. Because the early images were less sensitive in detecting tissue necrosis, we suggest that early imaging is not necessary.

Topics: Adolescent; Adult; Amputation, Surgical; Bone and Bones; Burns, Electric; Child; Debridement; Extremities; Female; Humans; Male; Middle Aged; Necrosis; Prospective Studies; Radionuclide Imaging; Radiopharmaceuticals; Regional Blood Flow; Technetium Tc 99m Medronate

Six patients with soft tissue injury secondary to different etiologic factors are presented. The degree and extent of tissue necrosis was precisely identified by scintigraphy. In two of these, radionuclide imaging helped to establish accurately the level of amputation that resulted in appropriate wound healing.

Topics: Adult; Burns, Electric; Child Abuse; Child, Preschool; Diabetic Neuropathies; Diphosphates; Humans; Male; Radionuclide Imaging; Rhabdomyolysis; Technetium; Technetium Tc 99m Medronate; Technetium Tc 99m Pyrophosphate

From June 1986 to May 1989, 17 patients who sustained high tension electric burns received preoperative 99mTc-MDP bone scan examinations. They were done to detect soft tissue and bone injury and also as a guide for debridement and amputation. From our experience, the correlation between the results of scanning and clinical findings is 88.9 per cent. They are very sensitive and reliable for decision making regarding debridement and limb amputation level when there is coagulation necrosis.

Topics: Adult; Bone and Bones; Burns, Electric; Debridement; Female; Humans; Male; Necrosis; Radionuclide Imaging; Technetium Tc 99m Medronate

Full skin thickness burns to the scalp involving bone damage are not uncommon. These are mainly caused by electricity, but there are some flame injuries. Investigation of the extent of bone damage by technetium bone scan and the use of CT head scan are recommended. Early closure of the defect using a flap is also recommended, even if wound contamination is present. The results can be very gratifying.

Topics: Adult; Aged; Aged, 80 and over; Burns, Electric; Humans; Male; Methods; Middle Aged; Radionuclide Imaging; Scalp; Skin Transplantation; Skull; Surgical Flaps; Technetium Tc 99m Medronate; Time Factors