[Burned palm reconstruction. Current concepts regarding grafting techniques, sensibility and hand function]

Area of Science:

• Plastic Surgery
• Burn Management
• Reconstructive Surgery

Context:

• Burn injuries to the palmar region of the hand present unique challenges for treatment and functional recovery.
• Evaluating outcomes of conservative versus operative interventions is crucial for optimizing patient care.
• Split-thickness skin grafting is a common surgical approach for hand burn reconstruction.

Purpose:

• To assess the subjective and objective outcomes of treating palmar hand burn injuries.
• To compare the efficacy of conservative and operative treatment modalities.
• To evaluate the results of sheet versus mesh split-thickness skin grafts in palmar burn reconstruction.

Summary:

• 110 patients with severe hand burns were evaluated, with 61 treated using sheet or mesh split-thickness skin grafts.
• Subjective outcomes included pain (visual analog scale) and aesthetics; objective measures included range of motion, grip strength, and sensibility (Semmes-Weinstein test).
• 90% patient satisfaction was reported, with excellent pain relief. Sheet grafts showed better aesthetic and grip strength results than mesh grafts, though sensibility was reduced post-burn.

Impact:

• Surgical reconstruction of palmar hand burns, particularly with sheet grafts, leads to favorable subjective and objective results.
• Specialized burn units are essential for achieving optimal outcomes in complex burn cases.
• Findings guide surgical choices, favoring sheet grafts for improved functional and aesthetic recovery in palmar burn patients.