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Author(s):  
Daegu Son

Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contractures involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many causes of hand deformities after burn. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less is the re-contraction and growth. The foot is an ideal donor site for skin graft on the hand. In particular, the instep or the area below the malleolar is a very good donor site. First web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, skin graft, and free flap step by step according to the degree of contraction.


Author(s):  
Nagaraj Gareikpatii

Background: Burn contracture of the hand can leave patients with severe functional and psychological limitations. This study evaluates the severity of the deformity and various reconstructive options in post-burn hand injuries.Methods: This work includes the study of 50 patients who underwent reconstruction for post-burn flexion contracture of the hand, including fingers, in the department of plastic surgery. The patients were treated between April 2007 to April 2009.Results: Males were more commonly affected by burn injuries and thermal burns were more common than electrical burns. The little finger showed higher involvement and contracture release followed by grafting was the commonly done reconstructive procedure.Conclusions: Split thickness skin graft (SSG) were more effective in reconstruction in thermal injuries, while cross finger flaps (CFF) showed more promise in electrical injuries of the hand. 


2020 ◽  
Vol 36 (6) ◽  
Author(s):  
Suneel Kumar ◽  
Faisal Akhlaq ◽  
Hyder Ali ◽  
Saba Kiran

Objective: To evaluate the efficacy of different surgical procedures on post burn contracture of hand. Methods: A quasi-experimental study design was conducted at the Department of Plastics and Reconstructive Surgery, Dow University of Health Science, DR. Ruth KM Pfau, Civil Hospital, Karachi, Pakistan from 1st June 2019 to 30th November 2019. Ninety-three participants of burned hand contracture of either gender, aged between 6- 60 years were included in the study. Resurfacing surgery with skin graft and loco-regional flaps were done according to type of contracture with individualization for each patient. All patients were kept under follow up for ninety days to assess efficacy of contracture release for each surgical procedure was noted. SPSS version 23 was used to analyse data. Results: Full thickness skin graft (FTSG) was performed in 60.2% cases, 17.2% with split thickness skin graft (STSG) and 12.9% with cross finger flaps. About 25% of recurrence was observed in cross finger flaps, whereas no recurrence was seen in Z-plasties and posterior interosseous flap. The significant association was between recurrence and surgical procedures (p<0.05). Conclusion: Z-plasty followed by FTSG was effective in the management of post burn contractures of hand. doi: https://doi.org/10.12669/pjms.36.6.2206 How to cite this:Kumar S, Khan FAA, Ali H, Kiran S. Surgical Management of Post Burn Hand Deformities. Pak J Med Sci. 2020;36(6):---------.  doi: https://doi.org/10.12669/pjms.36.6.2206 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Gentian Zikaj ◽  
Gjergji Belba ◽  
Gezim Xhepa

Background: Even that the entire hand represents 4 percent of the TBSA, The American Burn Association, the Advanced Trauma Life Support, and the Advanced Burn Life Support curricula all recognize the severity of hand burns by classifying these as injuries requiring treatment at a burn qualified center. Hand burns occur commonly both as part of larger burn injuries as well as isolated injuries. Due to damage to the skin and other parts of the hand, burns can lead to open wounds, disability, severe emotional and psychological complications, and economic burden. To further improve the effects of preventive measures, studies are needed to investigate the epidemiology, etiology, and outcomes of burn hand patient population. Aim: To give an overview of epidemiologic features and outcome of burn hand patients who admitted in our Service. This current study was performed in University Hospital Center “Mother Teresa” Tirana which is the only tertiary hospital in Albania.   Material and methods: In this retrospective study were included all patients who had combustion of the hands solely or hands accompanied with burns to other areas of the body, treated and followed up at our Service during the years 2011-2016. Results: Of the 333 included burn patients, 64% were males.The median age of women is 21.8 years, of men is 27.5 years and the median age total patients’ population is 25.9 years. About half of patients belong to the age group 20-60 years (49.5%) and only 10.2% belong to the age above 60 years.  In most of the cases (73.6%), the burn of hands is associated with burn of the other anatomical region, mostly forearm. Conclusion: The goal of wound management is to have the skin healed by post-burn in two weeks’ time. In many cases, this will occur nonoperatively with good wound care. The surgical treatment is used for less 30% than of patients.Surgical excision of the burn with split-thickness skin grafting should be undertaken as soon as it becomes obvious that wound healing will not be complete by post-burn day 14.The undesirable results of theburn of hands are presented in the 33% of the patients. The contractures were the main unfavorable outcome of the burned hand.


2018 ◽  
Vol 6 (5) ◽  
pp. 931-933 ◽  
Author(s):  
Gentian Zikaj ◽  
Gjergji Belba ◽  
Gezim Xhepa

INTRODUCTION: Hand burns occur commonly both as part of larger burn injuries as well as isolated injuries.AIM: To give an overview of epidemiologic features and outcome of burn hand patients who admitted to our Service. This study was performed at University Hospital Center “Mother Teresa” Tirana which is the only tertiary hospital in Albania.MATERIAL AND METHODS: This prospective study included all patients who had combustion of the hands solely or hands accompanied with burns to other areas of the body, treated and followed up at our service during the years 2011-2016.RESULTS: Of the 333 included burn patients, 64% were males. The median age of patients is 25.9 years. About half of patients belong to the age group 20-60 years (49.5%) and only 10.2% belong to the age of 60 years. In most of the cases (73.6%), the burn of hands is associated with the burn of the other anatomical region, mostly forearm.CONCLUSION: The surgical treatment is used for less 30% that of patients. The undesirable results of the burn of hands are presented in the 33% of the patients. The contractures were the main unfavourable outcome of the burned hand.


2017 ◽  
Vol 99 (6) ◽  
pp. e185-e187
Author(s):  
TOH Prasetyono ◽  
I Caroline

A 2-year-old boy presented to the plastic and reconstructive surgery outpatient clinic with bilateral post-burn hand flexion contracture. The contracture had been released twice elsewhere. The third surgical repair on one hand at a time was conducted by the author (TOHP). However, inadeq.uate compliance to the postoperative splinting and exercise led to the recurrence of the contracture in the following year. A customised two-sided splint was therefore created to ensure proper placement and compliance. Reinforcement to the parents to encourage the boy to practise active exercise on demand was also an integral part of the management. Good functional and cosmetic outcome were presented at 1-year follow-up. This case highlights the value of a two-sided splint for the management of post-burn hand flexion contracture in children whose compliance is inevitably cannot be guaranteed.


2017 ◽  
Vol 38 (6) ◽  
pp. e960-e965 ◽  
Author(s):  
Reg Richard ◽  
Ingrid S. Parry ◽  
Alexis Santos ◽  
W Scott Dewey

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