Paediatric hand burns

Hand burns are relatively common in children, caused by contact with hot surfaces, hot water, fireworks and flame. Appropriate conservative or surgical approach to their treatment with physical therapy can avoid or reduce functional and aesthetic consequences. Neurovascular compromise is one of the most serious complications of circumferential and deep hand burns and requires immediate decompression. Superficial burn injuries and most partial skin thickness burns can heal well using various epithelial dressings. Partial and full thickness skin burns require surgical access and use of autologous skin grafts, skin flaps or dermal regeneration templates. Bloodless excision with a surgical knife or hydro-surgical system, good haemostasis, scalp or thigh split thickness skin grafts, supported by platelet-rich plasma, and negative pressure wound treatment are approaches that generally provide good outcomes in children. The available dermal regeneration templates, with their structure and support for healing, replace dermal layer with equal or better final functional and aesthetic results. In the absence of periosteum or tendon sheaths after debridement of a burn wound, skin grafts are options for treatment. Within the first 24 hours after burn injury, physical therapy with active and passive exercises should be initiated. Scars and contractures after paediatric hand burns can lead to partial loss of function. The multimodal approach, in addition to surgery, involves massage, silicone gel and sheaths, compression gloves and PDL and CO2 fractional ablation laser treatments. Surgical techniques for scar correction of paediatric hand are local transposition and sliding flaps and full thickness skin grafts. Key words: BURNS; HAND; CHILD; TRANSPLANTS

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