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'physical therapy' /exp OR 'physical therapy' AND ( 'hand burn' /exp OR 'hand burn' )

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7: Hand Burns Kowalske K.J.Phys i c a l M e d i c i ne a nd Re ha b i l i t at i on C l i n i c s o f Nor t h A m e r i c a 2011 22:2 (249-259

abstract : Burn rehabilitation cannot be reviewed without a significant focus on the hand. Although thesurface area of the hand is only 3%, the functional consequences cause extreme impairment. Acomprehensive team approach from initial evaluation through long-term follow up is essential to maximizethe functional outcome in this population. 2011 Elsevier Inc.

Link http://www.sciencedirect.com/science/article/pii/S1047965111000337

11: Excellent reliability of the sollerman hand function test for patients with burned hands Weng L.-Y., Hsieh C.-L., Tung K.-Y., Wang T.-J., Ou Y.-C., Chen L.-R., Ban S.-L., Chen W.-W., Liu C.-F.J o u r n a l o f Bu r n Ca r e and Re s e a r c h 2010 31:6 (904-910

abstract: The purpose of this study was to identify the minimal detectable change (MDC) of the Sollermanhand function test (SHT) for patients with burned hands. Twelve subjects were studied, giving a total of 21burned hands (10 right hands and 11 left hands). Each subject received two sessions of SHT assessment,held at 7-to 10-day intervals. Three raters were recruited to observe and assign scores for the patients'performance during the tests. The MDC was calculated based on standard measurement error, and theintraclass correlation coefficient was applied to examine relative reliability. Results showed that both intra-and interrater MDCs were acceptable (6.7 and 6.9 points, respectively) and that both intra-and interraterrelative reliabilities were excellent (intraclass correlation coefficients = 0.98). According to this study, theSHT was found to have appropriate MDC and relative reliability in monitoring changes over time for patientswith burned hands. The MDCs of SHT calculated in this study are useful in determining whether any change

in score is the result of more than random error. Copyright 2010 by the American Burn Association.

Link:http://journals.lww.com/burncareresearch/pages/articleviewer.aspx?year=2010&issue=11000&article=00007&type=abstract

13: Rehabilitation of the Burned Hand Moore M.L., Dewey W.S., Richard R.L.Ha n d Cl i n i c s 2009 25:4 (529-541)

abstract : Successful outcomes following hand burn injury require an understanding of the rehabilitationneeds of the patient. Rehabilitation of hand burns begins on admission, and each patient requires a specificplan for range of motion and/or immobilization, functional activities, and modalities. The rehabilitation care

plan typically evolves during the acute care period and during the months following injury. 2009 ElsevierInc. All rights reserved.

Link : http://www.sciencedirect.com/science/article/pii/S0749071209000444

16: Treatment of hand burns Siemers F., Mailnder P.Unf a l l c h i r u rg 2009 112:6 (558-564

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Abstract : Although burn injuries of the hand only account for approximately 2.5 -3% of the total body surfacearea (TBSA), they are of great importance due to functional outcome, appearance and economic aspects.Initial treatment and diagnosis are important factors, which influence the further course of thermal injuries ofthe hand and which are found in up to 80% of treated burn injuries. Early decision-making is necessary ifescharotomy or skin grafting is indicated. After preliminary evaluation and wound management adifferentiation between non-surgical and surgical procedures is necessary. In the case of full thicknessthermal injuries, debridement and skin grafting should be carried out. Further interdisciplinary managementinvolves different professional groups as surgeons and physical therapists. Fitting pressure garments andtreatment of scar formation are integral parts of the successful rehabilitation of hand burns. 2009 SpringerMedizin Verlag.

Link: http://link.springer.com/article/10.1007%2Fs00113-009-1657-3

32: The acute and subacute management of the burned hand Luce E.A.Cl i n i c s i n P l as t i c Su rge r y 2000 27:1 (49-63)

Management of the severely burned upper extremity remains a significant challenge to the mostexperienced clinician. An understanding of the underlying mechanism that uncorrected could culminate in anegative outcome is the key to formulation of a successful treatment plan. Initial proper splinting, avoidanceof edema, the appropriate sequencing and integration of physical therapy, and judicious surgicalintervention, all considered within the framework of the individual patient, are the components of thetreatment plan that yields the most consistently good results.

51 Long-term functional results of selective treatment of hand burns

Abstract: Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burnservice of the Massachusetts General Hospital. Long-term evaluation showed that early incision and

immediate autografting of deep second degree, mixed second and third degree, and third degree full-thickness hand burns resulted in 93 percent, 95 percent, and 93 percent, respectively, excellent to goodfunctional results. There was no significant difference in results in patients with superficial second degreeburns treated nonsurgically with silver nitrate dressings and early physical therapy compared with results inpatients with deep second degree, mixed second and third degree, and third degree hand burns treated withearly excision and grafting. No patient with fourth degree burns had excellent to good results. Permanentdamage was related to extent of original injury to the extensor tendons and joint capsules. On the basis ofthis broad experience, it is believed that all burned hands judged unlikely to heal within 3 weeks will benefitfrom early excision and grafting by experienced surgical personnel.

Link : http://www.sciencedirect.com/science/article/pii/S0002961085800490

53 Principles of treatment of the burned hand Zabel G.Or t hopa d i s c he P r a x i s 1982 18:4 (272-274)

Abtract: Diagnosis and therapy of burns of the hands require great care; while conservative treatment isreserved for slight burns, deep burns of the second and third degree should be surgically treated with splitskin transplants as the method of choice subsequent to necrectomy. Later plastic surgical interventions arefrequently necessary. The importance ofphysical therapy as follow-up treatment must be emphasized.

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54: Prospective randomized treatments for burned hands: Nonoperative vs. operative. Preliminary report Edstrom L.E., Robson M.C., Macchiaverna J.R., Scala A.D.Sc a n d i na v i an J o u r na l o f P l as t i c a nd Re c ons t r uc t i ve Su rge r y 1979

Abstract: It has been suggested that deep partial -thickness burns of the hand which remain unhealed by 14days should be excised and totally resurfaced. Controlled data supporting this suggestion is not available.Therefore, a prospective randomized study was performed on 222 burns of the hand to evaluate if excisionand skin grafting had any advantage over conservative management. Full-thickness burns were eliminatedfrom the series by excision and grafting them as soon as possible after the diagnosis had been made. Toeliminate the very superfical burns, randomization did not take place until the wound had remainedunhealed for ten days and would not heal for at least another week. In the two groups, the first ten dayswere managed similarly with topical antibacterials, escharotomies when necessary, and splinting in the'safe' position. Conservatively managed hands were treated with scarlet red gauze dressing as soon as alleschar had been removed. Those cases randomized into the excision and grafting group were oper atedupon approximately day 14.Physical therapy was the same in both groups except for the immediate periodafter grafting. Results were recorded by active and passive joint measurements and photographs onpredetermined days throughout the study. In this study, spontaneous healing, taking as much as five weeks,gave acceptable results, comparable to excision and grafting performed at two weeks. The use of range ofmotion exercise, accurate splinting and pressure allowed optimal healing and prevented stiffness andcontractures in both groups. There was no significant difference between the two treatment modalities.

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