[Experiences of tangential excision of burned hands]

Tangential excision and immediate grafting of deep burns of the hands enable wound closure within 14 days. Mobility of the hand is rapidly restored, pain is practically omitted, scar formation is minimized, and sensitivity is restored to normal in the majority of cases. Considering only surviving patients accounting for a total of 247 hand (hospitalisation from January 1974 to June 1977), we tangentially excised 118 hands. Two thirds of the tangential excisions needed no more corrections. One third had corrections of interdigital webs, dermabrasion of graft margins, excision of scars, or correction of contractions mainly of the fifth finger. On questioning, half of the patients admitted increased vulnerability of the transplanted skin but were not impeded by this. Work incapacity in those cases in which the hands determined the uptake of manual labour was only 5 weeks.