Management of the burned hand has tasked the therapist as trials and tribulations tasked Job. Poor functional results occur despite what appears to be optimum care. Because of these failures, there is no one accepted management of the severely burned hand. Immediate immobilization of the hand will encourage skin coverage, and early mobilization to preserve function will be at the risk of skin coverage. The time-honored management of burned hands has been to splint the hand in a modified position of function. Repeated dressing changes and debridement are done until a satisfactory granulation bed develops to accept the graft.1,2 A long period of physical therapy to rehabilitate stiff joints and multiple plastic procedures to correct contractures follows. The resulting edema of the burned hands and the prolonged immobilization were the greatest factors endangering complete return of function.
Dr. John Moncrief, with his group at Brooke Army Burn Center, recognized
Batdorf JW, Cammack KV, Colquitt RD. The Silicone Dressing Management of the Burned Hand. Arch Surg. 1969;98(4):469-471. doi:10.1001/archsurg.1969.01340100101013