Acute hand burns in children: management and long-term outcome based on a 10-year experience with 698 injured hands.

Abstract:

OBJECTIVE:To document long-term results associated with an coordinated plan of care for acutely burned hands in children. SUMMARY AND BACKGROUND DATA:Optimal hand function is a crucial component of a high-quality survival after burn injury. This can be achieved only with a coordinated approach to the injuries. Long-term outcomes associated with such a plan of care have not been previously reported. METHODS:Over a 10-year period, 495 children with 698 acutely burned hands were managed at a regional pediatric burn facility; 219 children with 395 injured hands were followed in the authors' outpatient clinic for at least 1 year and an average of >5 years. The authors' approach to the acutely burned hand emphasizes ranging and splinting throughout the hospital stay, prompt sheet autograft wound closure as soon as practical, and the selective use of axial pin fixation and flaps. Long-term follow-up, hand therapy, and reconstructive surgery are emphasized. RESULTS:Normal functional results were seen in 97% of second-degree and 85% of third-degree injuries; in children with burns involving underlying tendon and bone, 70% could perform activities of daily living and 20% had normal function. Reconstructive hand surgery was required in 4.4% of second-degree burns, 32% of third-degree burns, and 65% of those with injuries involving underlying bone and tendon. CONCLUSIONS:When managed in a coordinated long-term program, the large majority of children with serious hand burns can be expected to have excellent functional results.

journal_name

Ann Surg

journal_title

Annals of surgery

authors

Sheridan RL,Baryza MJ,Pessina MA,O'Neill KM,Cipullo HM,Donelan MB,Ryan CM,Schulz JT,Schnitzer JJ,Tompkins RG

doi

10.1097/00000658-199904000-00016

subject

Has Abstract

pub_date

1999-04-01 00:00:00

pages

558-64

issue

4

eissn

0003-4932

issn

1528-1140

journal_volume

229

pub_type

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