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'physical therapy'/exp OR 'physical therapy' AND ('hand burn'/exp OR 'hand burn')

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7: Hand Burns
Kowalske K.J.
Physical Medicine and Rehabilitation Clinics of North America 2011 22:2(249-259
abstract : Burn rehabilitation cannot be reviewed without a significant focus on the hand. Although the
surface area of the hand is only 3%, the functional consequences cause extreme impairment. A
comprehensive team approach from initial evaluation through long-term follow up is essential to maximize
the functional outcome in this population. 2011 Elsevier Inc.
Link http://www.sciencedirect.com/science/article/pii/S1047965111000337
11: Excellent reliability of the sollerman hand function test for patients with burned hands
Weng L.-Y., Hsieh C.-L., Tung K.-Y., Wang T.-J., Ou Y.-C., Chen L.-R., Ban S.-L., Chen W.-W., Liu C.-F.
J ournal of Burn Care and Research 2010 31:6(904-910
abstract: The purpose of this study was to identify the minimal detectable change (MDC) of the Sollerman
hand function test (SHT) for patients with burned hands. Twelve subjects were studied, giving a total of 21
burned hands (10 right hands and 11 left hands). Each subject received two sessions of SHT assessment,
held at 7-to 10-day intervals. Three raters were recruited to observe and assign scores for the patients'
performance during the tests. The MDC was calculated based on standard measurement error, and the
intraclass correlation coefficient was applied to examine relative reliability. Results showed t hat both intra-
and interrater MDCs were acceptable (6.7 and 6.9 points, respectively) and that both intra-and interrater
relative reliabilities were excellent (intraclass correlation coefficients = 0.98). According to this study, the
SHT was found to have appropriate MDC and relative reliability in monitoring changes over time for patients
with burned hands. The MDCs of SHT calculated in this study are useful in determining whether any change
in score is the result of more than random error. Copyright 2010 by the American Burn Association.
Link:http://journals.lww.com/burncareresearch/pages/articleviewer.aspx?year=2010&issue=1100
0&article=00007&type=abstract
13: Rehabilitation of the Burned Hand
Moore M.L., Dewey W.S., Richard R.L.
Hand Clinics 2009 25:4(529-541)
abstract : Successful outcomes following hand burn injury require an understanding of the rehabilitation
needs of the patient. Rehabilitation of hand burns begins on admission, and each patient requires a specific
plan for range of motion and/or immobilization, functional activities, and modalities. The rehabilitation care
plan typically evolves during the acute care period and during the months following injury. 2009 Elsevier
Inc. All rights reserved.
Link : http://www.sciencedirect.com/science/article/pii/S0749071209000444

16: Treatment of hand burns
Siemers F., Mailnder P.
Unfallchirurg 2009 112:6(558-564
Abstract : Although burn injuries of the hand only account for approximately 2.5-3% of the total body surface
area (TBSA), they are of great importance due to functional outcome, appearance and economic aspects.
Initial treatment and diagnosis are important factors, which influence the further course of thermal injuries of
the hand and which are found in up to 80% of treated burn injuries. Early decision-making is necessary if
escharotomy or skin grafting is indicated. After preliminary evaluation and wound management a
differentiation between non-surgical and surgical procedures is necessary. In the case of full thickness
thermal injuries, debridement and skin grafting should be carried out. Further interdisciplinary management
involves different professional groups as surgeons and physical therapists. Fitting pressure garments and
treatment of scar formation are integral parts of the successful rehabilitation of hand burns. 2009 Springer
Medizin Verlag.
Link: http://link.springer.com/article/10.1007%2Fs00113-009-1657-3

32: The acute and subacute management of the burned hand
Luce E.A.
Clinics in Plastic Surgery 2000 27:1(49-63)
Management of the severely burned upper extremity remains a significant challenge to the most
experienced clinician. An understanding of the underlying mechanism that uncorrected could culminate in a
negative outcome is the key to formulation of a successful treatment plan. Initial proper splinting, avoidance
of edema, the appropriate sequencing and integration of physical therapy, and judicious surgical
intervention, all considered within the framework of the individual patient, are the components of the
treatment plan that yields the most consistently good results.

51 Long-term functional results of selective treatment of hand burns
Abstract: Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn
service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and
immediate autografting of deep second degree, mixed second and third degree, and third degree full -
thickness hand burns resulted in 93 percent, 95 percent, and 93 percent, respectively, excellent to good
functional results. There was no significant difference in results in patients with superficial second degree
burns treated nonsurgically with silver nitrate dressings and early physical therapy compared with results in
patients with deep second degree, mixed second and third degree, and third degree hand burns treated with
early excision and grafting. No patient with fourth degree burns had excellent to good results. Permanent
damage was related to extent of original injury to the extensor tendons and joint capsules. On the basis of
this broad experience, it is believed that all burned hands judged unlikely to heal within 3 weeks will benefit
from early excision and grafting by experienced surgical personnel.
Link : http://www.sciencedirect.com/science/article/pii/S0002961085800490

53 Principles of treatment of the burned hand
Zabel G.
Orthopadische Praxis 1982 18:4(272-274)
Abtract: Diagnosis and therapy of burns of the hands require great care; while conservative treatment is
reserved for slight burns, deep burns of the second and third degree should be surgically treated with split
skin transplants as the method of choice subsequent to necrectomy. Later plastic surgical interventions are
frequently necessary. The importance ofphysical therapy as follow-up treatment must be emphasized.
54: Prospective randomized treatments for burned hands: Nonoperative vs. operative. Preliminary report
Edstrom L.E., Robson M.C., Macchiaverna J.R., Scala A.D.
Scandinavian J ournal of Plastic and Reconstructive Surgery 1979

Abstract: It has been suggested that deep partial-thickness burns of the hand which remain unhealed by 14
days should be excised and totally resurfaced. Controlled data supporting this suggestion is not available.
Therefore, a prospective randomized study was performed on 222 burns of the hand to evaluate if excision
and skin grafting had any advantage over conservative management. Full -thickness burns were eliminated
from the series by excision and grafting them as soon as possible after the diagnosis had been made. To
eliminate the very superfical burns, randomization did not take place until the wound had remained
unhealed for ten days and would not heal for at least another week. In the two groups, the first ten days
were managed similarly with topical antibacterials, escharotomies when necessary, and splinting in the
'safe' position. Conservatively managed hands were treated with scarlet red gauze dressing as soon as all
eschar had been removed. Those cases randomized into the excision and grafting group were oper ated
upon approximately day 14.Physical therapy was the same in both groups except for the immediate period
after grafting. Results were recorded by active and passive joint measurements and photographs on
predetermined days throughout the study. In this study, spontaneous healing, taking as much as five weeks,
gave acceptable results, comparable to excision and grafting performed at two weeks. The use of range of
motion exercise, accurate splinting and pressure allowed optimal healing and prevented stiffness and
contractures in both groups. There was no significant difference between the two treatment modalities.