Problems in the treatment of burnt hands.

The treatment of burnt hands is not simple. By emphasizing problems that are frequently encountered, I have attempted to stress certain methods of treatment based on sound principles of burn wound care and skin grafting. Great responsibility rests on the person who does the initial skin grafting in the full-thickness loss burn of the hand, just as there is on the person who is treating the burnt hand prior to grafting. Such responsibility demands the maintenance of adequate range of motion during the preparatory wound care, after the important initial grafting, and during the rehabilitation period, so that maximum final function can be attained. If one does not recognize the importance of these principles of treatment, a stiff, malpositioned, contracted hand will result that is impossible to adequately correct, leading to significant permanent disability and loss of earning power. All who treat burned patients should realize that the major permanent disability of burns is in the hands. Proper treatment based on sound principles can greatly reduce or eliminate that disability.