Oral electrical injuries in children are usually the result of a toddler sucking or biting into a live electrical cord. The commissure of the mouth will show extensive damage from the electrical current "arcing," resulting in gray-white tissue with elevated red margins. Bleeding does not usually occur at this stage. Minor pain and swelling usually result.
Emergency treatment is based on the extent of the wound. Debridement, systemic antibiotics, and a tetanus booster should be considered. Parents should be cautioned that the eschar will slough in 5-7 days and that significant bleeding could occur at this time.
A commissure splint is fabricated within days of the injury and is worn for up to 12 months following the burn to prevent microstomia secondary to wound contraction.
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