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Based on a knowledge of electropathophysiology, a recommended treatment has been proposed for the management of extensive high-voltage electrical burns. Early, aggressive, surgical intervention consisting of adequate decompression fasciotomy and wound debridement has been emphasized as the first line of treatment. Frequent redebridements under general anesthesia are important to the preservation of viable tissue. Early coverage procedures or attempts at primary closure following decompression are contraindicated in high-voltage injuries. This method of treatment in eight cases of high-voltage, electrical injury has preserved viable tissue, decreased the incidence of fatal sepsis and renal shutdown, decreased patient morbidity, and generally facilitated patient rehabilitation.

Water skiing, boat racing, skin and scuba diving, and pleasure boat cruising are increasing in popularity. As a result the incidence of injuries secondary to motor propellers is becoming more frequent. In a ten-year period from 1963 to 1973, I collected a total of nine cases. In some amputations were necessary, and in other cases amputations occurred at the time of injury. Problems with bacterial flora occurring in open sea water versus salt water enclosed near docks and fresh lake water are discussed. A review of the orthopedic literature revealed sparse information regarding propeller injuries.