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Burn rehabilitation cannot be reviewed without a significant focus on the hand. The surface area of the hand is only 3%, but the functional consequences cause extreme impairment. A comprehensive team approach from initial evaluation through long-term follow up is essential to maximize the functional outcome in this population.
Burn rehabilitation cannot be reviewed without a significant focus on the hand. The surface area of the hand is only 3%, but the functional consequences cause extreme impairment. A comprehensive team approach from initial evaluation through long-term follow up is essential to maximize the functional outcome in this population.
Burn rehabilitation cannot be reviewed without a significant focus on the hand. The surface area of the hand is only 3%, but the functional consequences cause extreme impairment. A comprehensive team approach from initial evaluation through long-term follow up is essential to maximize the functional outcome in this population.
'physical therapy'/exp OR 'physical therapy' AND ('hand burn'/exp OR 'hand burn')
Potenciales textos que sirven ( ninguno texto completo) 7: Hand Burns Kowalske K.J. Physical Medicine and Rehabilitation Clinics of North America 2011 22:2(249-259 abstract : Burn rehabilitation cannot be reviewed without a significant focus on the hand. Although the surface area of the hand is only 3%, the functional consequences cause extreme impairment. A comprehensive team approach from initial evaluation through long-term follow up is essential to maximize the functional outcome in this population. 2011 Elsevier Inc. Link http://www.sciencedirect.com/science/article/pii/S1047965111000337 11: Excellent reliability of the sollerman hand function test for patients with burned hands Weng L.-Y., Hsieh C.-L., Tung K.-Y., Wang T.-J., Ou Y.-C., Chen L.-R., Ban S.-L., Chen W.-W., Liu C.-F. J ournal of Burn Care and Research 2010 31:6(904-910 abstract: The purpose of this study was to identify the minimal detectable change (MDC) of the Sollerman hand function test (SHT) for patients with burned hands. Twelve subjects were studied, giving a total of 21 burned hands (10 right hands and 11 left hands). Each subject received two sessions of SHT assessment, held at 7-to 10-day intervals. Three raters were recruited to observe and assign scores for the patients' performance during the tests. The MDC was calculated based on standard measurement error, and the intraclass correlation coefficient was applied to examine relative reliability. Results showed t hat both intra- and interrater MDCs were acceptable (6.7 and 6.9 points, respectively) and that both intra-and interrater relative reliabilities were excellent (intraclass correlation coefficients = 0.98). According to this study, the SHT was found to have appropriate MDC and relative reliability in monitoring changes over time for patients with burned hands. The MDCs of SHT calculated in this study are useful in determining whether any change in score is the result of more than random error. Copyright 2010 by the American Burn Association. Link:http://journals.lww.com/burncareresearch/pages/articleviewer.aspx?year=2010&issue=1100 0&article=00007&type=abstract 13: Rehabilitation of the Burned Hand Moore M.L., Dewey W.S., Richard R.L. Hand Clinics 2009 25:4(529-541) abstract : Successful outcomes following hand burn injury require an understanding of the rehabilitation needs of the patient. Rehabilitation of hand burns begins on admission, and each patient requires a specific plan for range of motion and/or immobilization, functional activities, and modalities. The rehabilitation care plan typically evolves during the acute care period and during the months following injury. 2009 Elsevier Inc. All rights reserved. Link : http://www.sciencedirect.com/science/article/pii/S0749071209000444
16: Treatment of hand burns Siemers F., Mailnder P. Unfallchirurg 2009 112:6(558-564 Abstract : Although burn injuries of the hand only account for approximately 2.5-3% of the total body surface area (TBSA), they are of great importance due to functional outcome, appearance and economic aspects. Initial treatment and diagnosis are important factors, which influence the further course of thermal injuries of the hand and which are found in up to 80% of treated burn injuries. Early decision-making is necessary if escharotomy or skin grafting is indicated. After preliminary evaluation and wound management a differentiation between non-surgical and surgical procedures is necessary. In the case of full thickness thermal injuries, debridement and skin grafting should be carried out. Further interdisciplinary management involves different professional groups as surgeons and physical therapists. Fitting pressure garments and treatment of scar formation are integral parts of the successful rehabilitation of hand burns. 2009 Springer Medizin Verlag. Link: http://link.springer.com/article/10.1007%2Fs00113-009-1657-3
32: The acute and subacute management of the burned hand Luce E.A. Clinics in Plastic Surgery 2000 27:1(49-63) Management of the severely burned upper extremity remains a significant challenge to the most experienced clinician. An understanding of the underlying mechanism that uncorrected could culminate in a negative outcome is the key to formulation of a successful treatment plan. Initial proper splinting, avoidance of edema, the appropriate sequencing and integration of physical therapy, and judicious surgical intervention, all considered within the framework of the individual patient, are the components of the treatment plan that yields the most consistently good results.
51 Long-term functional results of selective treatment of hand burns Abstract: Four hundred seventy-eight patients with hand burns (786 hands) were treated at the burn service of the Massachusetts General Hospital. Long-term evaluation showed that early incision and immediate autografting of deep second degree, mixed second and third degree, and third degree full - thickness hand burns resulted in 93 percent, 95 percent, and 93 percent, respectively, excellent to good functional results. There was no significant difference in results in patients with superficial second degree burns treated nonsurgically with silver nitrate dressings and early physical therapy compared with results in patients with deep second degree, mixed second and third degree, and third degree hand burns treated with early excision and grafting. No patient with fourth degree burns had excellent to good results. Permanent damage was related to extent of original injury to the extensor tendons and joint capsules. On the basis of this broad experience, it is believed that all burned hands judged unlikely to heal within 3 weeks will benefit from early excision and grafting by experienced surgical personnel. Link : http://www.sciencedirect.com/science/article/pii/S0002961085800490
53 Principles of treatment of the burned hand Zabel G. Orthopadische Praxis 1982 18:4(272-274) Abtract: Diagnosis and therapy of burns of the hands require great care; while conservative treatment is reserved for slight burns, deep burns of the second and third degree should be surgically treated with split skin transplants as the method of choice subsequent to necrectomy. Later plastic surgical interventions are frequently necessary. The importance ofphysical therapy as follow-up treatment must be emphasized. 54: Prospective randomized treatments for burned hands: Nonoperative vs. operative. Preliminary report Edstrom L.E., Robson M.C., Macchiaverna J.R., Scala A.D. Scandinavian J ournal of Plastic and Reconstructive Surgery 1979
Abstract: It has been suggested that deep partial-thickness burns of the hand which remain unhealed by 14 days should be excised and totally resurfaced. Controlled data supporting this suggestion is not available. Therefore, a prospective randomized study was performed on 222 burns of the hand to evaluate if excision and skin grafting had any advantage over conservative management. Full -thickness burns were eliminated from the series by excision and grafting them as soon as possible after the diagnosis had been made. To eliminate the very superfical burns, randomization did not take place until the wound had remained unhealed for ten days and would not heal for at least another week. In the two groups, the first ten days were managed similarly with topical antibacterials, escharotomies when necessary, and splinting in the 'safe' position. Conservatively managed hands were treated with scarlet red gauze dressing as soon as all eschar had been removed. Those cases randomized into the excision and grafting group were oper ated upon approximately day 14.Physical therapy was the same in both groups except for the immediate period after grafting. Results were recorded by active and passive joint measurements and photographs on predetermined days throughout the study. In this study, spontaneous healing, taking as much as five weeks, gave acceptable results, comparable to excision and grafting performed at two weeks. The use of range of motion exercise, accurate splinting and pressure allowed optimal healing and prevented stiffness and contractures in both groups. There was no significant difference between the two treatment modalities.