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Effectiveness of Early Compression Therapy in Acute Hand Burns: A Randomized Controlled Trial
João Pedro da Silva Mendes1, Fátima Catarina Figueiredo Marques1, António José Ferreira de Sousa1
1Coimbra Burns Unit, Plastic Surgery and Burns Department, Unidade Local de Saúde de Coimbra, 3004-561 Coimbra, Portugal.
None:
Hand burns pose significant rehabilitation challenges. While compression therapy is well-established for chronic scar management, evidence for its application during the acute phase remains limited. This study evaluated the effectiveness of early compression therapy on edema, passive range of motion (PROM), and grip strength in acute hand burns. A randomized controlled trial was conducted at a tertiary burn center between November 2023 and March 2025. Thirty-two adult patients (40 hands) with superficial and/or deep partial-thickness hand burns were randomly assigned to control (standard care; 16 patients, 20 hands) or intervention groups (standard care plus compression therapy at 8 mmHg; 16 patients, 20 hands). Outcomes measured at baseline and the end of the acute phase included hand edema, metacarpophalangeal joint PROM, and grip strength. Statistical analyses included paired and independent t-tests, analysis of covariance, and effect size calculations. Groups were homogeneous at baseline. The intervention group demonstrated significantly greater improvements: PROM increased 23.6 ± 12.8° vs 8.6 ± 16.7° (P = .003, Cohen's d = 1.00), grip strength improved 4.2 ± 5.9 kg vs declined 0.8 ± 5.0 kg (P = .006, d = 0.92), and edema reduced 4.2 ± 2.9 cm vs 2.3 ± 2.1 cm (P = .025, d = -0.74). Analysis of covariance confirmed significant effects after adjusting for baseline values (all P < .01). No adverse events occurred. Early compression therapy during acute hand burns significantly improves outcomes with large effect sizes. These findings support considering earlier initiation of compression therapy (48-72 h postinjury) as part of acute hand burn management protocols.
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