Practice guidelines for the management of electrical injuries.

There has been increasing emphasis on the development of practice guidelines and validated measurements to evaluate surgical practice. Initiatives such as the National Surgical Quality Improvement Program (NSQIP) have demonstrated the importance of an outcome-based approach to improving surgical care. The development of guidelines and outcome-based benchmarks requires established standards of practice that should be based on level I data from welldesigned prospective randomized trials. Electrical burns are potentially devastating injuries with both shortand long-term sequelae. In 2001, the American Burn Association published a set of practice guidelines for various aspects of burn care in the Journal of Burn Care and Rehabilitation. However, guidelines for the management of electrical burns were not included. Two fundamental—and controversial—issues in the management of electrical burns are cardiac monitoring and evaluation and treatment of the injured upper extremity. We have reviewed and analyzed the available literature in an effort to develop practice guidelines for these two important issues.