Initial assistance to hand burns: literature review
DOI:
https://doi.org/10.15448/1980-6108.2015.2.20908Keywords:
hands, wounds and injuries, burns, primary treatment.Abstract
Aims: To address, through a literature review, the management of hand burns, with emphasis on the initial care.
Methods: Between February and July 2015, 30 articles selected in the databases Medline/PubMed, LILACS, SciELO and Google Scholar were reviewed. Both the English and Portuguese languages were included in the search. Selected articles were published in the last 10 years and matched the following descriptors: hand burn; hand injury; acute treatment; primary treatment; and their counterparts in Portuguese.
Results: Classification of burns is displayed, including depth, extent and aggravating factors. The initial management that avoid complications such as claw hand, compartment syndrome and infection is addressed. Early procedures include occlusive dressings, escharotomy, fasciotomy, and carpal tunnel opening, followed by dressings with topical antimicrobial agents, debridement and grafting. Controversial aspects are discussed on the most appropriate time for surgical intervention, if it is necessary.
Conclusions: The correct early approach to hand burns can prevent irreversible consequences. The appropriate management on hand burns includes since the initial clinical evaluation of the burned area by a general practitioner, to the realization of early procedures in order to prevent limb function loss and unnecessary future reconstructions. The high incidence of this type of burn also stresses the importance of a proper conduct.
Downloads
References
Pardini A, Freitas A. Cirurgia da Mão: Lesões não-traumáticas. 2 ed. Rio de Janeiro: Medbook; 2008.
Kamolz LP, Kitzinger HB, Karle B, Frey M. The treatment of hand burns. Burns. 2009;35(3):327-37. http://dx.doi.org/10.1016/j.burns.2008.08.004
Mckee DM. Acute management of burn injuries to the hand and upper extremity. J Hand Surg Am. 2010; 35A:1542-4. http://dx.doi.org/10.1016/j.jhsa.2010.03.019
Richards WT, Vergara E, Dalaly DG, Coady-Fariborzian L, Mozingo DW. Acute surgical management of hand burns. J Hand Surg Am. 2014;39(10):2075-85.e2. http://dx.doi.org/10.1016/j.jhsa.2014.07.032
Narikawa R, Michelski DA, Hiraki PY, Ueda T, Nakamoto HA, Junior PT, Ferreira MC. Análise epidemiológica da mão queimada no Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Rev Bras Queimaduras. 2011;10(3):89-92.
Duffy BJ, McLaughlin PM, Eichelberger MR. Assessment, triage, and early management of burns in children. Clin Pediatr Emerg Med. 2006;7(2):82-93. http://dx.doi.org/10.1016/j.cpem.2006.04.001
Evers LH, Bhavsar D, Mailänder P. The biology of burn injury. Exp Dermatol. 2010;19(9):777-83. http://dx.doi.org/10.1111/j.1600-0625.2010.01105.x
Llooyd ECO, Rodgers BC, Michener M, Williams MS. Outpatient Burns: Prevention and Care. Am Fam Physician. 2012;85(1):25-32
Alharbi Z, Piatkowski A, Dembinski R, Reckort S, Grieb G, Kauczok J, Pallua N. Treatment of burns in the first 24 hours: simple and practical guide by answering 10 questions in a step-by-step form. World J Emerg Surg. 2012;7(1):13. http://dx.doi.org/10.1186/1749-7922-7-13
Grunwald TB, Garner WL. Acute Burns. Plast Reconstr Surg. 2008;121(5):311e-319e. http://dx.doi.org/10.1097/PRS.0b013e318172ae1f
Júnior JBG, Moscozo MVA, Filho ALL, Menezes CMGG, Tavares FMO, Oliveira GM, Júnior WNG. Tratamento de pacientes queimados internados em Hospital Geral. Rev Soc Bras Cir Plást. 2007;22(4):228-32.
Jenkins JA, Schraga ED. Emergent Management of Thermal Burns. EUA; 2014 [Updated 2014 Feb; cited March 2015]. Available from: http://emedicine.medscape.com/article/769193-overview#showall
Fufa DT, Chuang SS, Yang JY. Postburn contractures of the hand. J Hand Surg Am. 2014;39(9):1869-76. http://dx.doi.org/10.1016/j.jhsa.2014.03.018
Pan BS, Vu AT, Yakuboff KP. Management of the acutely burned hand. J Hand Surg Am. 2015; 40 (7):1477-84. http://dx.doi.org/10.1016/j.jhsa.2015.02.033
Piccolo NS, Piccolo MS, Piccolo PD, Piccolo-Daher R, Piccolo ND, Piccolo MT. Escharotomies, fasciotomies and carpal tunnel release in burn patients – review of the literature and presentation of an algorithm for surgical decision making. Handchir Mikrochir Plast Chir. 2007;39(3):161-7. http://dx.doi.org/10.1055/s-2007-965322
Castro RJA, Leal PC, Sakata RK. Tratamento da dor em queimaduras. Rev Bras Anestesiol. 2013;63(1):149-58. http://dx.doi.org/10.1590/S0034-70942013000100013
Junior ATR. Acute compartment syndrome. Washington; 2015 [Updated 2015 Feb; cited 2015 March 14]. Available from: http://emedicine.medscape.com/article/307668-overview
Stracciolini A, Hammerberg EM. Acute compartment syndrome of the extremities. 2014 [updated 2014 Jul; cited 2015 March 14]. Available from: http://www.uptodate.com/contents/acute-compartment-syndrome-of-the-extremities
Mullins RF, Alam B, Mian MAH. Carpal Tunnel Syndrome following burns. Ann Burns Fire Disasters. 2008;21(3):153-5.
Bolgiani AN, Serra MCVF. Atualização no tratamento local das queimaduras. Rev Bras Queimaduras. 2010;9(2):38-44.
Filho JAL, Dadalti P, Souza DC, Souza PRC, Silva MAL, Takiya CM. Enxertia de pele em oncologia cutânea. An Bras Dermatol. 2006;81(5):465-72. http://dx.doi.org/10.1590/S0365-05962006000500010
Henrique DM, Silva LD, Costa ACR, Rezende APMB, Santos JAS, Menezes MM, Maurer TC. Controle de infecção no centro de tratamento de queimados: revisão de literatura. Rev Bras Queimaduras. 2013;12(4):230-4.
Pan BS, Vu AT, Yakuboff KP. Management of the Acutely Burned Hand. J Hand Surg Am. 2015;40(7):1477-84. http://dx.doi.org/10.1016/j.jhsa.2015.02.033
Mohammadi AA, Bakhshaeekia AR, Marzban S, Abbasi S, Ashraf AR, Mohammadi MK, Toulide-Ie HR, Tavakkolian AR. Early excision and skin grafting versus delayed skin grafting in deep hand burns (a randomised clinical controlled trial). Burns. 2011;37(1):36-41. http://dx.doi.org/10.1016/j.burns.2010.02.005
Vaitsman GP, Guimarães VG, Freire RF, Esbérard F, Filho FV, Silva MAL. Excisão precoce e autoenxertia cutânea em queimadura de mãos. Rev Bras Cir Plást. 2010;25(3):94.
Yast AC, Şenel E, Saydam M, Özok G, Çoruh A, Yorgancı K. Guideline and treatment algorithm for burn injuries. Ulus Travma Acil Cerrahi Derg. 2015;21(2):79-89. http://dx.doi.org/10.5505/tjtes.2015.88261
Daigeler A, Kapalschinski N, Lehnhardt M. Therapy of burns. Der Chirurg. 2015;86(4):389-401. http://dx.doi.org/10.1007/s00104-014-2919-3
Cowan AC, Stegink-Jansen WC. Rehabilitation of hand burn injuries: Current updates. Injury. 2013;44(3):391-6. http://dx.doi.org/10.1016/j.injury.2013.01.015
Bhattacharya S. Avoiding unfavorable results in postburn contracture hand. Indian J Plast Surg. 2013;46(2):434-44. http://dx.doi.org/10.4103/0970-0358.118625
Ribeiro LMB, de Morais VS, Fachinelli, FA. Sindactilia pós-queimadura da mão. Rev Bras Cir Plást. 2013;28(1):130-2. http://dx.doi.org/10.1590/S1983-51752013000100022
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
