Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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The more severe forms are attended with a considerable degree of shock, which is not only more profound, but also lasts much longer than the shock in an ordinary burn of corresponding severity. The parts at the point of entrance of the current are charred to a greater or lesser depth. The eschar is at first dry and crisp, and is surrounded by a zone of pallor. For the first thirty-six to forty-eight hours there is comparatively little suffering, but at the end of that time the parts become exceedingly painful. In a majority of cases, in spite of careful purification, a slow form of moist gangrene sets in, and the slough spreads both in area and in depth, until the muscles and often the large blood vessels and nerves are exposed. A line of demarcation eventually forms, but the sloughs are exceedingly slow to separate, taking from three to five times as long as in an ordinary burn, and during the process of separation there is considerable risk of secondary haemorrhage from erosion of large vessels.
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