The isolated burned palm in children: Epidemiology and long-term sequelae

The isolated burn of the palm is a typical injury in young children. Positi oning and splinting in small hands is difficult, and long-term sequelae of these injuries are not uncommon. The objective of the present study was to assess the outcome of palm burns and to identify the risk factors for long- term sequelae. All patients admitted to our hospital affected with isolated palm injuries between January of 1988 and January of 1998 were reviewed. In total, 120 pe diatric patients were admitted with isolated palm burns; 110 patients (91.7 percent) had partial-thickness burns, and 10 patients (8.3 percent) had fu ll-thickness burns. Only four patients (3.3 percent) required excision and skin autografting, but all patients whose palms were operated on in the acu te phase developed burn contractures. Sixteen patients (13.3 per cent) deve loped palmar contractures, and more than half of them (56 percent) required reconstructive procedures. All palm burns that healed in more than 3 weeks developed scarring and sequelae (p < 0.05 compared with no sequelae). Pediatric palmar burns are benign injuries with a low incidence of late seq uelae. However, flame and contact burns are more prone to develop scarring. Excision and autografting should be performed on wounds that take over 3 w eeks to heal, but it does not prevent late sequelae.