Article
Hand burns in austere enviroment
Search Medline for
Authors
-
Yousef Alloun
- Damascus University, Idleb Atmeh, Syria
| Published: | February 6, 2020 |
|---|
Outline
Text
Introduction: Hand burns in austere environment can cause contractures, joint dislocations, deformities and loss of the function of fingers. Deep hand burns (including 3rd degree and deep 2nd degree) might lead to loss of function of the hand, unless these burns are treated properly. Early identification of the burn degree, correct dressings in functional position, early debridement of deep burns and covering the defect with flaps or skin graft followed by physiotherapy are necessary to promote early healing, reduce infections, shorten hospitalization, prevent contractures and maintain hand function.
Inadequate treatment of deep hand burns may end with infections, dislocated joints and contracture of the fingers and may lead to amputations of parts of the hand.
Objective: In austere environment with limited access to trained hand surgeons we could prevent hand contractures, deformities and preserve hand function by proper treatment of deep burn followed by physiotherapy.
Methods: Case report of 5 cases of deep hand burns in austere environment context.
Discussion: In order to obtain better results, the degree of the burn should be determined early. It is essential that burn debridement is performed early, dressings are done regularly and physiotherapy should be provided for a long period. If the treatment is not started early, the fibrosis will occur in the site of the burn and contractures will be formed, dislocation of the joints and adhesions of the fingers may happen. The end result will be loss of function of the hand.
Results:
One patient with incorrect initial treatment of hand burns ended with amputation of fingers.
Two patients have received early skin grafting with physiotherapy, followed -up for two months and have got good results.
Two cases had contractures in the hands and fingers, although there have been good initial treatment, but had no physiotherapy follow-up.
Conclusion: In spite of lack of advanced medical equipment, unavailability of hand surgeon, and lack of specialized physiotherapy proper treatment at early phase after the hand burns followed by physiotherapy could maintain hand function and prevent contractures or deformities of the hand.
