Salvage procedures for mutilated burnt hands

In a severely burnt hand one of the most difficult problems in reconstructive surgery is the prevention of contractures. Early skin grafting, and the reduction of oedema and joint stiffness by early mobilization, will minimize contraction, but will not altogether prevent it. When the dominant hand has also suffered damage, the need for a reconstructive procedure is absolutely essential, and by far the best functional and cosmetic results are achieved with the use of local tissue from the damaged digits. This paper describes various reconstructive salvage procedures for severely deformed hands.