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April 1969

The Silicone Dressing Management of the Burned Hand

Author Affiliations

Las Vegas, Nev
From the Lion's Burn Center, Southern Nevada Memorial Hospital, Las Vegas.

Arch Surg. 1969;98(4):469-471. doi:10.1001/archsurg.1969.01340100101013

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

Artz, C.P., and Reiss, E.:  The Treatment of Burns , W. B. Saunders Co., 1957, p 133.
Robertson, D.C.:  The Management of the Burned Hand ,  J Bone Joint Surg 40A:625-632 ( (June) ) 1958.
Moncrief, J.A.:  Third Degree Burns of the Dorsum of the Hand ,  Amer J Surg 96:535-538, 1958.Crossref
Moncrief, J.A.; Switzer, W.S.; and Rose, L.R.:  Primary Excision and Grafting in the Treatment of Third Degree Burns of the Dorsum of the Hand ,  Plast Reconstr Surg 33:305-361 ( (April) ) 1964.Crossref
Gerow, F.J., et al:  Silicone Immersion Treatment of the Severely Burned Patient ,  Excerpta Med , International Congress series, No. (66) , Washington, DC, October, 1963.
Miller, J.E.; Hardy, S.B.; and Shira, M.:  Treatment of Burns of Hands With Silicone Dressings and Early Motion ,  J Bone Joint Surg 47A:938-943 ( (July) ) 1965.
Dow Corning 360 Medical Fluid, Dow Coming Medical Pamphlet, May 9, 1966.
McGregor, R.R.:  Toxicology of Certain Silicone Fluids , The Bulletin, Dow Corning Center for Aid to Medical Research, vol 2, p 15.