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

Objective To document long-term results associated with an coordinated plan of cave 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 w ere managed at a regional pediatric burn facility; 219 children with 395 in jured 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 burne d hand emphasizes ranging and splinting throughout the hospital stay, promp t 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 re constructive 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 tend on and bone, 70% could perform activities of daily living and 20% had norma l function. Reconstructive hand surgery was required in 4.4% of second-degr ee burns. 32% of third-degree burns, and 85% of those with injuries involvi ng underlying bone and tendon. Conclusions When managed in a coordinated long-term program, the large majo rity of children with serious hand burns can be expected to have excellent functional results.