Purpose
The objective of this study was to analyze the prevalence, indications, and type of
reconstructive surgery and predictors of the outcomes of reconstructive surgery after
hand burns.
Methods
A retrospective cohort study was conducted that included all patients admitted with
acute hand burns in the Dutch burn centers from January 1998 through December 2002.
The details of reconstruction including frequency, timing, indication, and techniques
were collected over a 10-year follow-up period.
Results
Hand burns were seen in 42% (n = 562 of 1,334) of all patients admitted with acute
burns. Reconstructive surgery during the 10-year follow-up period was required in
15%. Contractures, especially of the first web space and little finger, were the most
frequent indications for reconstructive surgery. Web spaces 1 to 3 and the little
finger were the location most frequently operated on. The most frequently performed
surgical technique was release of the contractures and the use of a random flap. Eighty
percent of the reconstructive surgery patients required more than 1 reconstructive
procedure, most often within 2 years of the initial injury. Secondary operations at
the same location were required in 12%. In 40% of the patients, the first reconstructive
surgery was performed within the first postburn year.
Significant independent factors related to the need for reconstructive hand surgery
were a larger area of full-thickness burns and surgical treatment of the hand during
the acute phase.
Conclusions
Reconstructive surgery was required in 15% of patients who sustained hand burns. The
majority of the patients requiring reconstructive surgery of the hand needed 2 or
more operations to correct the contractures of the hand. Contractures of the little
finger and first web space were the locations most frequently operated on. Patients
with more extensive burns and who required hand surgery during the acute phase were
more likely to need reconstructive surgery.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: March 27, 2017
Accepted:
February 13,
2017
Received:
May 22,
2016
Footnotes
The research was financially supported by a grant of the Dutch Burns Foundation (11.102).
The Dutch Burn Repository group consists of (1) Burn Centre Beverwijk: D.C. Baas, E.C. Kuijper, F.R.H. Tempelman, A.F.P.M. Vloemans, P.P.M. van Zuijlen; (2) Burn Centre Rotterdam: J. Dokter, A. van Es, C.H. van der Vlies; (3) Burn Centre Groningen: G.I.J.M. Beerthuizen, J. Eshuis, J. Hiddingh, S. Scholten-Jaegers; and (4) Association of Dutch Burn centres: M.E. van Baar, E. Middelkoop, M.K. Nieuwenhuis, A. Novin, M. Novin.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
