Steam press burns of the hand

Return to work after burn injury: a systematic review

Consequences of major burn injuries often include losing the ability to engage in basic life functions such as work or employment. As this is a developing area of importance in burn care, the goal of this study was to perform a systematic review of the burn literature to ascertain a comprehensive view of the literature and identify return to work (RTW) factors where possible. A search was conducted and peer-reviewed studies that investigated predictors and barriers of returning to work of those with burn injuries, published since 1970 and written in English, were examined. From the 216 articles initially identified in the search, 26 studies were determined to meet inclusion criteria. Across studies, the mean age was 33.63 years, the mean TBSA was 18.94%, and the average length of stay was 20 days. After 3.3 years (41 months) postburn, 72.03% of previously employed participants had returned to some form of work. Important factors of RTW were identified as burn location, burn size, treatment variables, age, pain, psychosocial factors, job factors, and barriers. This systematic review suggests multiple conclusions. First, there is a significant need for attention to this area of study given that nearly 28% of all burn survivors never return to any form of employment. Second, the RTW literature is in need of coherent and consistent methodological practices, such as a sound system of measurement. Finally, this review calls for increased attention to interventions designed to assist survivors' ability to function in an employed capacity.

The use of latissimus dorsi muscle flap in the aesthetical reconstruction of heat-press injury of the hand

We present a successful case of aesthetic reconstruction utilizing free latissimus dorsi muscle flap transfer. A large quantity of skin of the dorsum of hand and finger was lost. The dorsum of the index, long and ring fingers was severely damaged, such that extensor tendons were necrotic and all digital bones and the second metatarsal bone were exposed with partial necrosis. In addition, the proximal interphalangeal joints (PIP) were also exposed. To cover exposed bones and the tendons of dorsum of the hand, a free latissimus dorsi muscle flap was transferred, and then meshed skin covered the muscle, resulting in a mitten-like condition. After cutting the grafted muscle and skin to divide fingers, the grafted muscle was shaved to create the contour of fingers and dorsum of the hand, and then sheet grafting was performed. Six years after the operation, although the movement of fingers was restricted, an acceptable contour of the hand was obtained. The patient is satisfied with the result and does not desire any further surgery. In conclusion, the use of latissimus dorsi muscle flap is a method of choice not only to cover damaged hand but also to give contour in the aesthetic reconstruction of a hand presenting after heat-press injury.

Steam press hand burns: a serious burn injury

Steam presses cause full-thickness burns when the operator's extremity is caught between the buck and the head of the steam press. Patients with serious steam press burns should be referred to a regional burn center for excision of the full-thickness burn and coverage by either a split-thickness skin graft or a flap. The safety features in steam presses that could prevent this serious injury include: (1) emergency safety releases, (2) peripheral safety bars, and (3) two-hand operator control.