Epidemiology and Outcome Analysis of 470 Patients with Hand Burns: A Five-Year Retrospective Study in a Major Burn Center in Southwest China

[Hand burns in pediatrics]

Burns of the hands in pediatrics are an important topic in combustiology. The hand plays a huge role in the development of mental and physical skills in a child. A retrospective analysis of electronic medical records of 282 victims with hand burns who were treated in Moscow Pediatric Hospital No. 9 named by G.N. Speransky was carried out. The study showed that most often children receive burns of the hands in the first three years of life, the main thermal agent is hot liquid. 35 patients had different types of surgery: excision with one stage or delayed grafting, enzymatic debridement and mechanical debridement. Silver containing atraumatic hydrocolloid dressings were used on all stages of treatment. Clinical examples demonstrate different variants of surgical tactics used in children from 0 till 6 years. Surgery types depend of the depth of damage to the integumentary tissues and deep structures of the hand and fingers. The work highlights diagnostic and clinical approaches to the management of patients with this pathology. The algorithm of conservative and surgical treatment of patients with burns II-III and III degree in the area of the palmar and dorsal surfaces of the hand and fingers is presented. This algorithm also includes tactics at rehabilitation stages restoring functional and aesthetic disorders. Compliance all recommendations contributes to the speedy socialization of patients in this age group.

Reconstruction of soft tissue defects of hand: A systematic approach

Background and Objective

A thorough insight into the management of hand injuries can shape the approach of a surgeon in order to achieve optimal outcomes for the patients. The aim of this study was to share our experience in reconstruction of the hand and establishing an algorithm for classification and treatment of hand injuries.

Methods

This is a descriptive cross sectional study and was conducted from January 2020 to August 2022 at Burns and Plastic Surgery center, Peshawar. Data was collected from medical records about the patient demographics, mechanism of injury and type of procedures done. Defect size was classified into small (<5cm), medium (5cm to 10 cm) and large (>10cm). The defect site and size was cross tabulated against the method of soft tissue reconstruction in order to make the algorithm for reconstruction of hand injuries. Data was analyzed using SPSS.

Results

The study population included 41 (75.9%) male and 13 (24.1%) female patients, mean age 31.56±14.1. Machine injuries (33.3%) and electric burns (24.1%) were the most common cause of hand soft tissue defects. The most commonly performed flap was Posterior introsseous artery (PIA) flap, followed by First dorsal metacarpal artery (FDMA) flap. Flap necrosis was observed in three cases (5.6%).

Conclusion

This treatment algorithm for coverage of soft tissue defects in hand injuries will help with the decision making process of hand reconstruction and has didactic value for novice surgeons. It will also form the foundation for further work on this aspect of hand injuries.

[Pay more attention to the management of burn wounds of special causes and sites]

The treatment of burn wounds of special causes and sites is a very challenging clinical work. In this paper, we briefly discussed the incidence rates of chemical burns, electric burns, facial burns, hand burns, and perineal burns, as well as the complexity and severity of pathological injury of the corresponding wound tissue. In addition, we briefly discussed the main principles and methods of clinical treatment, as well as the difficult problems to be solved. It is hoped to attract attention and provide reference for further improving the overall treatment ability of burns.