Therapeutic Strategies and Predictors of Functional Impairment in Hand Burns: A Retrospective Single-Center Study.

Abstract

Hand burns pose complex clinical challenges due to the intricate anatomy of the hand and its indispensable role in daily activities. In this retrospective cohort study, we evaluated 88 adult patients admitted to a specialized burn center with burns involving one or both hands. We collected demographics, burn characteristics, and clinical variables from medical records, and assessed functional outcomes one year after injury using the Disabilities of the Arm, Shoulder, and Hand (DASH) score. Nonparametric tests compared patient subgroups, a six-factor multivariable regression (age, %TBSA, depth, digital involvement, bilateral involvement, amniotic-membrane use) identified predictors of more severe functional impairment. Although larger burns required longer hospital stays, neither burn size nor depth emerged as independent predictors of hand function in the multivariable model. In contrast, anatomical burn site, particularly digital and bilateral hand involvement, was strongly associated with higher DASH scores, highlighting the importance of the precise location of the burn in long-term recovery. Age also played a critical role, with older patients showing worse outcomes regardless of other clinical factors. Surgical management varied across the cohort, with the use of amniotic membrane grafts standing out as a potentially favorable approach. Patients receiving these grafts showed lower DASH scores, suggesting better preservation of hand function compared to other methods. While these findings reinforce the need to focus on specific anatomical areas and patient age in treatment planning, they also point to innovative biologic materials as a promising avenue for functional recovery. Multicenter studies may help refine these observations and guide burn care in the future.