Management of Acute Hand Burns

Hands are the most commonly involved body part in burns. In greater than 90% cases, the burns are severe and carry with them a significant risk of morbidity even though the mortality associated is relatively less. Hand burns present challenges to the treating surgeon on many fronts. One is the assessment of severity and depth of the injury itself, where, clinical examination remains the gold standard. The other is the choice and performance of the most appropriate surgical procedure to provide optimal outcomes in terms of function and aesthetics. The one challenge with most impact is probably that of post-operative care and rehabilitation to preserve function at a level where the patient can carry on with activities of daily living at the least. The need for reconstructive surgery also arises at a later date to address issues like post-burn contractures and unstable scars. In this review, we present the approach to management of hand burns in the acute setting with consideration to both conservative and surgical modalities. Keywords: Hand burns, Laser Doppler imaging, Fasciotomy, Splinting, Allografts.