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Treatment of Hand Burns

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Essential Burn Care for Non-Burn Specialists
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Abstract

The hands, despite comprising <10% of overall body surface area, have a major impact on patient function and health related quality of life. Hands are readily visible to both the patient and others; as such, it has a potential impact on a person’s self-perception. The majority of hand burns initially present in non-burn centers. Knowledge of hand anatomy as well as accurate initial evaluation and management of the burned hand by non-burn practitioners is essential to optimize patient outcomes. Second and third degree burns and burns that are unlikely to heal within 2 weeks should be referred to a qualified burn surgeon. The basic tenets of hand burn care are to (1) promote a wound healing environment, (2) maintain circulation, (3) prevent infection, (4) obtain wound closure, and (5) maintain motion. This chapter focuses on the anatomy, evaluation, and initial treatment of hand burns and discusses some common long-term problems associated with hand burns.

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References

  1. Pan BS, Vu AT, Yakuboff KP. Management of the acutely burned hand. J Hand Surg Am. 2015;40:1477–84.

    Article  PubMed  Google Scholar 

  2. Keyerman PA, Andres LA, Lucas HD, et al. Reconstruction of the burned hand. Plast Reconstr Surg. 2011;127:752–9.

    Article  Google Scholar 

  3. Johnson SP, Sebastin SJ, Rehim SA, Chung KC. The importance of hand appearance as a patient-reported outcome in hand surgery. Plast Reconstr Surg Glob Open. 2015;3(11):e552. https://doi.org/10.1097/GOX.0000000000000550.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Palmieri TL, Nelson-Mooney K, Kagan R, Stubbs T, et al. Impact of hand burns on health-related quality of life in children younger than 5 years. J Trauma. 2012;73(3):S197–204.

    Article  Google Scholar 

  5. Maddern LH, Cadogan JC, Emerson MP. ‘Outlook’: a psychological service for children with a different appearance. Clinical child psychology and psychiatry. 2006;11(3):431–43.

    Article  PubMed  Google Scholar 

  6. Schmidt HM, Lanz U. Chirugische anatomie der hand 2, uberarb, und aktualisierte aufl. Ed. Stuttgart. G. Thieme; 2003.

    Google Scholar 

  7. Pham TN, Hanley C, Palmieri TL, Greenhalgh DG. Results of early excision and full-thickness grafting of deep palm burns in children. J Burn Care Rehabil. 2001;22:54–7.

    Article  CAS  PubMed  Google Scholar 

  8. Wibbenmeyer L, Gittelman MA, Kluesner K, Liao J, et al. A multicenter study of preventable contact burns from glass fronted gas fireplaces. J Burn Care Res. 2015;36(1):240–5.

    Article  PubMed  Google Scholar 

  9. Spauwen PH, Brown IF, Sauer EW, et al. Management of fingernail deformities after thermal injury. Scand J Plast Reconstr Surg Hand Surg. 1987;21:253–5.

    CAS  PubMed  Google Scholar 

  10. Simpson RL, Flaherty ME. The burned small finger. Clin Plast Surg. 1992;19:673–82.

    Article  CAS  PubMed  Google Scholar 

  11. ACS Guidelines. Guidelines for trauma centers caring for burn patients. In: Resources for optimal care of the injured patient, Chapter 14; 2014, pp. 200–106.

    Google Scholar 

  12. Cuttle L, Kempf M, Liu PY, et al. The optimal duration and delay of first aid treatment for deep partial thickness burn injuries. Burns. 2010;36(5):673–9.

    Article  PubMed  Google Scholar 

  13. Venter TH, Karpelowsky JS, Rode H. Cooling of the burn wound: the ideal temperature of the coolant. Burns. 2007;33(7):917–22.

    Article  CAS  PubMed  Google Scholar 

  14. Cho YS, Choi YH. Comparison of three cooling methods for burn patients: a randomized clinical trial. Burns. 2017;43(3):502–8.

    Article  PubMed  Google Scholar 

  15. Rovee DT, Kurowsky CA, Labun J. Local wound environment and epidermal healing. Mitotic response. Arch Dermatol. 1972;106:330–4.

    Article  CAS  PubMed  Google Scholar 

  16. Jan SN, Khan FA, Bashir MM, et al. Comparison of laser doppler imaging (LDI) and clinical assessment in differentiating between superficial and deep partial thickness burn wounds. Burns. 2018;44:405–13.

    Article  PubMed  Google Scholar 

  17. Pan SC. Burn blister fluids in the neovascularization stage of burn wound healing: a comparison between superficial and deep partial-thickness burn wounds. Burn Trauma. 2013;1:27–31.

    Article  Google Scholar 

  18. Smith MA, Munster AM, Spence RJ. Burns of the hand and upper limb-a review. Burns. 1998;24:493–505.

    Article  CAS  PubMed  Google Scholar 

  19. Palmieri TL, Greenhalgh DG. Topical treatment of pediatric patients with burns: a practical guide. Am J Clin Dermatol. 2002;3:529–34.

    Article  PubMed  Google Scholar 

  20. Sheridan, Salisbury RE, Wright P. Evaluation of early excision of dorsal burns of the hand. Plast Reconstr Surg. 1982;69:670.

    Article  Google Scholar 

  21. Robson MC, Smith DJ Jr, VanderZee AJ, et al. Making the burned hand functional. Clin Plast Surg. 1992;19:663–71.

    Article  CAS  PubMed  Google Scholar 

  22. Greenhalgh DG, Barthel PP, Warden GD. Comparison of back versus thigh donor sites in pediatric patients with burns. J Burn Care Rehabil. 1993;14:21–5.

    Article  CAS  PubMed  Google Scholar 

  23. Sheridan RL, Baryza MJ, Pessina MA, et al. Acute hand burn in children: management and long-term outcome based on a 10-year experience with 698 injured hands. Ann Surg. 1999;229:558–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Atiyeh BS, El Khatib AM, Dibo SA. Pressure garment therapy (PGT) of burn scars: evidence-based efficacy. Ann Burns Fire Disasters. 2013;26(4):205–12.

    CAS  PubMed  PubMed Central  Google Scholar 

  25. Schwarz RJ. Management of postburn contractures of the upper extremity. J Burn Care Res. 2007;28:212–9.

    Article  PubMed  Google Scholar 

  26. Ebid AA, Ibrahim AR, Omar MT, El Baky AMA. Long-term effects of pulsed high-intensity laser therapy in the treatment of post-burn pruritus: a double-blind, placebo-controlled, randomized study. Lasers Med Sci. 2017;32(3):693–701. https://doi.org/10.1007/s10103-017-2172-3. Epub 2017 Feb 23.

    Article  PubMed  Google Scholar 

  27. Reynertson KA, Garay M, Nebus J, Chon S, Kaur S, Mahmood K, et al. Anti-inflammatory activities of colloidal oatmeal (Avena sativa) contribute to the effectiveness of oats in treatment of itch associated with dry, irritated skin. J Drugs Dermatol. 2015;14(1):43–8.

    PubMed  Google Scholar 

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Correspondence to Tina L. Palmieri .

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Palmieri, T.L. (2023). Treatment of Hand Burns. In: Lee, J.O. (eds) Essential Burn Care for Non-Burn Specialists. Springer, Cham. https://doi.org/10.1007/978-3-031-28898-2_8

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  • DOI: https://doi.org/10.1007/978-3-031-28898-2_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-28897-5

  • Online ISBN: 978-3-031-28898-2

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