Acute Management of Hand Burns

The hand is extremely susceptible to burn injuries, and hand burns can occur in up to 90% of all major burns. A thorough neurovascular examination of the hand should be performed in the acute setting. Escharotomies are required in patients with full-thickness or circumferential burns, when perfusion of the upper extremity is compromised. The decision for excision and grafting is based on whether the wound will heal in the first 2 to 3 weeks after the burn injury. Acute care and resuscitation are always importance in this patient population; subsequent care leads to optimal hand functionality and cosmetic long-term outcomes.