Clinical Profile and Acute-Phase Management Modalities of Pediatric Hand Burn: A Retrospective Study.

Abstract

Although the hands constitute approximately 5% of the total body surface area (TBSA), the sequelae and subsequent functional outcomes following hand burns (HBs) significantly impact the quality of life for affected patients. HBs, which frequently accompany severe burns and are often neglected, deserve additional attention in the management of burns of this anatomical region, as they are responsible for a majority of postburn morbidity. In addition, many questions remain unanswered in almost every aspect of HB management. Moreover, recent articles suggest that the primary issue of optimal timing concerning skin closure for HBs, which seemed well answered, has been questioned, and even this fundamental question may require further investigation. Appropriate initial management of HBs commencing from the acute phase in children remains of great importance in optimizing functional outcomes and minimizing long-term scar formation. In this context, our primary purpose in this retrospective cohort study was to present the epidemiological characteristics of HBs in children as a whole and to discuss the incidence and mechanisms, in addition to the outcomes of superficial and deep HB acute-phase management modalities. During the 5-year study period, HBs were detected in 27% (n = 422) of 1580 hospitalized pediatric burn patients in the Adana Faculty of Medicine-University of Health Sciences (AFM-UHS) Burn Center. Movement and functional status of the hands were evaluated with a simple qualitative staging system adapted from the original scoring tools used by Stiefel et al., and Sheridan et al. Good, moderate, and poor scores in the study were graded as Category A, Category B, and Category C, respectively. According to the hand movement and function assessment categorization, 84% of the cases were observed as Category-A who had good/normal regular movements/functions of the hands/fingers, followed by Category-B and -C with percentages of 15 and 1, respectively, during the 5.8 ± 3.4 month follow-up period.