Management of the burned hand.

Current concepts in the management of acute and chronic injury to hands due to thermal burns are presented. A review of relevant functional anatomy and its alteration by the burn process is outlined. The maintenance of wrist extension, metacarpophalangeal flexion, and an open thumb web is critical in the acute phase. The physical therapist, using splints and regular exercise, is the key person in maintaining this position. The use of antibacterial agents, surgical debridement, and skin grafting is discussed. Surgical methods of reconstruction in chronic burns, the long-term role of the physical therapist, and the use of compression garments to minimize scar are stressed.