Long-Term Functional Outcomes after Hand Burns: A Monocentric Controlled Cohort Study

Area of Science:

• Reconstructive surgery
• Burn care
• Hand surgery

Background:

• Hand burns are common in severe burn injuries, significantly impacting patient quality of life despite a small total burn surface area (TBSA).
• Long-term functional outcomes after hand burns are not well-documented.
• This study addresses the scarcity of long-term data on hand functionality post-burn.

Purpose of the Study:

• To investigate long-term functional results in patients with hand burns.
• To analyze the influence of burn depth, unilateral vs. bilateral involvement, and isolated vs. non-isolated burns on hand function.
• To adopt a patient-centric approach using validated questionnaires for outcome assessment.

Main Methods:

• A controlled cohort study comparing 61 patients with hand burns (2005-2022) to 63 healthy, matched controls.
• Utilized Disabilities of the Arm, Shoulder, and Hand Questionnaire (Quick-DASH) and Michigan Hand Questionnaire (MHQ) for patient-reported functional outcomes.
• Employed the Patient and Observer Scar Assessment Scale (patient scale) for scar quality assessment.

Main Results:

• Hand burn patients reported significantly worse long-term function across all MHQ domains and in "overall function" and "work" on the Quick-DASH.
• Superficial burns in bilateral cases impaired daily living activities and aesthetics (p<0.05).
• Isolated burns led to work difficulties (p=0.03), while bilateral burns increased pain perception (p=0.025).

Conclusions:

• Patients with hand burns achieve satisfactory long-term function but do not fully regain pre-burn levels.
• Burn depth, unilateral/bilateral involvement, and isolated vs. non-isolated burns are key factors influencing perceived long-term hand function.
• Patient-reported outcomes are crucial for understanding the true impact of hand burns.