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Assessing Hand Function Post-Burn: A Systematic Review of Surgical vs. Enzymatic Debridement Using DASH/Quick-DASH
Paula de la Cruz Santos1, Olalla Saiz Vázquez1, Juan Hilario Ortiz-Huerta1
1Health Sciences Department, Universidad de Burgos, Burgos, España.
International Wound Journal
|March 26, 2026
Summary
Enzymatic debridement for hand burns, by preserving viable dermis, may improve functional outcomes compared to surgical methods. This approach shows promise for better recovery and rehabilitation in appropriate cases.
Area of Science:
- Burn care and reconstructive surgery
- Regenerative medicine and tissue engineering
Background:
- Hand burns significantly impair function and quality of life.
- Debridement is crucial for hand burn treatment.
- Enzymatic debridement offers selective tissue removal and potential for dermal preservation.
Purpose of the Study:
- To compare functional outcomes of hand burns treated with surgical versus enzymatic debridement.
- To evaluate the efficacy of different debridement methods using validated assessment tools.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Searches conducted in PubMed, Scopus, and Web of Science.
- Inclusion of studies using DASH, Quick-DASH, or MHQ for hand burn functional assessment in patients aged 16+.
Main Results:
- Seven studies met inclusion criteria (4 surgical, 3 enzymatic).
- Enzymatic debridement associated with better functional recovery, especially when preserving viable dermis and reducing grafting.
- DASH and MHQ scores favored enzymatic approaches, particularly with conservative management post-debridement.
Conclusions:
- Enzymatic debridement shows potential for improved functional outcomes in hand burns by preserving viable dermis and minimizing grafting.
- Surgical debridement remains vital for deep burns, but enzymatic methods may enhance early rehabilitation in suitable cases.
- Further research is needed due to methodological limitations and clinical heterogeneity in current studies.
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