Burn injuries to the hand are responsible for tremendous disability and loss of time from work resulting in tremendous economic burden to the patient. The acute management of these injuries is critical in maximizing the aesthetic and functional outcome. Key principles include proper wound management, minimum scar formation, static and dynamic splints to maintain the fingers and wrist in a functional position, application of a CPM machine and rigorous occupational therapy. Surgery is often required for soft tissue coverage of the burned hand in patients with deep second degree and third degree burns. This will entail partial and full-thickness skin grafting or flap reconstruction.
Chronic burn wounds often cause significant scarring and stiffness resulting in loss of function, including the activities of daily living (ADL’s) and return to work in the previous capacity. Management of the stiff hand, scarred hand and contractures (often with deformity) require complex surgical procedures. These procedures include flexor and extensor tenolyses, joint capsulotomies and capsulectomies, intrinsic muscle releases and soft tissue contracture releases often requiring a combination of skin grafts and local flaps. Rigorous occupational therapy and rehabilitation are crucial. Usually, multiple operations are required to obtain an optimal functional and aesthetic result.
Dr. Norman Weinzweig has tremendous experience in the management of acute and chronic burns of the hand. Having worked at several major Burn Centers, including Detroit Receiving Hospital, Dr. Weinzweig has treated hundreds of badly burned hands with excellent functional results. Dr. Weinzweig has written chapters on Hand Burns in several major texts. In fact, Dr. Weinzweig has been granted a patent for his invention of a continuous passive motion machine adaptor apparatus for hand burn patients (#5,261,393 issues November 16, 1993). The Chicago Institute for Hand Surgery & Rehabilitation is a major referral center for the secondary reconstruction of the burned hand where various procedures are performed including soft tissue reconstruction for skin coverage using flaps and skin grafts as well as contracture releases of the soft tissues, tendons and joints in order to restore useful function and aesthetics to the hand.