OBJECTIVE: To reduce amputation rate of most severe pattern (Type III) of electrical burns of wrist. METHODS: Early wrist decompression followed by selective transfusion of dextran, PGE1, low molecule heparin to prevent thrombosis of injured radial and ulnar arteries, vascular bridging across the distal forearm and wrist to the hand soon after the appearance of circulatory failure to the hand. Free tissue transfer, especially the use of greater omentum and the innovated abdominal flaps, to repair the circumferential wounds of the wrists are recommended. RESULTS: A group of 102 limbs of 90 patients were treated in the last 10 years, among them the amputation rate of most severe pattern (Type III) of electrical burns of wrists was significantly reduced from 80% to 38.9% compared with 10 years before. CONCLUSION: A comprehensive treatment including the use of anticoagulation drugs, vascular reconstruction, sophisticated surgical repair of the wound are effective in reducing the amputation rate of electrical burns of wrists.