THE ACUTELY BURNED HAND - MANAGEMENT AND OUTCOME BASED ON A 10-YEAR EXPERIENCE WITH 1047 ACUTE HAND BURNS

Optimal hand function has a very positive impact on the quality of sur vival after burn injury, Over a 10-year period, 659 patients with 1047 acutely burned hands were managed at the Sumner Redstone Burn Center of the Massachusetts General Hospital. Our approach to acutely burned hands emphasizes ranging and splinting throughout hospitalization, pro mpt sheet autograft wound closure as soon as practical, and the select ive use of axial pin fixation and flaps. This approach is associated w ith normal function in 97% of those with superficial injuries and 81% of those with deep dermal and full-thickness injuries requiring surger y. Although only 9% of those with injuries involving the extensor mech anism, joint capsule, or bone had normal functional outcomes, 90% were able to independently perform activities of daily living.