Initial assistance to hand burns: literature review

  • Jefferson Braga Silva Hospital São Lucas da PUCRS Faculdade de Medicina PUCRS
  • Márcio Pereira Lima Ferdinando Hospital São Lucas da PUCRS
  • João Guilherme Meinem Garbin Pontifícia Universidade Católica do Rio Grande do Sul
  • Victoria d'Azevedo Silveira Pontifícia Universidade Católica do Rio Grande do Sul
Keywords: hands, wounds and injuries, burns, primary treatment.


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.


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Author Biographies

Jefferson Braga Silva, Hospital São Lucas da PUCRS Faculdade de Medicina PUCRS

PhD. Livre Docente em Cirurgia da Mão, Universidade Federal de São Paulo (UNIFESP), Chefe do Serviço de Cirurgia da Mão e Microcirurgia Reconstrutiva do Hospital São Lucas da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS). Diretor da Faculdade de Medicina da PUCRS. Ex-Presidente da Sociedade Brasileira da Cirurgia da Mão. Ex-Presidente da Sociedade Brasileira de Microcirurgia.

Márcio Pereira Lima Ferdinando, Hospital São Lucas da PUCRS

MD. Pós-Graduação em Cirurgia Geral PUCRS. Médico Residente em Serviço Cirurgia da Mão e Microcirurgia Reconstrutiva PUCRS.

João Guilherme Meinem Garbin, Pontifícia Universidade Católica do Rio Grande do Sul
Acadêmico de Medicina
Victoria d'Azevedo Silveira, Pontifícia Universidade Católica do Rio Grande do Sul
Acadêmica de Medicina PUCRS


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.

Mckee DM. Acute management of burn injuries to the hand and upper extremity. J Hand Surg Am. 2010; 35A:1542-4.

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.

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.

Evers LH, Bhavsar D, Mailänder P. The biology of burn injury. Exp Dermatol. 2010;19(9):777-83.

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.

Grunwald TB, Garner WL. Acute Burns. Plast Reconstr Surg. 2008;121(5):311e-319e.

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:

Fufa DT, Chuang SS, Yang JY. Postburn contractures of the hand. J Hand Surg Am. 2014;39(9):1869-76.

Pan BS, Vu AT, Yakuboff KP. Management of the acutely burned hand. J Hand Surg Am. 2015; 40 (7):1477-84.

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.

Castro RJA, Leal PC, Sakata RK. Tratamento da dor em queimaduras. Rev Bras Anestesiol. 2013;63(1):149-58.

Junior ATR. Acute compartment syndrome. Washington; 2015 [Updated 2015 Feb; cited 2015 March 14]. Available from:

Stracciolini A, Hammerberg EM. Acute compartment syndrome of the extremities. 2014 [updated 2014 Jul; cited 2015 March 14]. Available from:

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.

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.

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.

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.

Daigeler A, Kapalschinski N, Lehnhardt M. Therapy of burns. Der Chirurg. 2015;86(4):389-401.

Cowan AC, Stegink-Jansen WC. Rehabilitation of hand burn injuries: Current updates. Injury. 2013;44(3):391-6.

Bhattacharya S. Avoiding unfavorable results in postburn contracture hand. Indian J Plast Surg. 2013;46(2):434-44.

Ribeiro LMB, de Morais VS, Fachinelli, FA. Sindactilia pós-queimadura da mão. Rev Bras Cir Plást. 2013;28(1):130-2.

How to Cite
Braga Silva, J., Pereira Lima Ferdinando, M., Meinem Garbin, J. G., & d’Azevedo Silveira, V. (2015). Initial assistance to hand burns: literature review. Scientia Medica, 25(2), ID20908.
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