Hand Burns

Hand burns occur commonly both as part of larger burn injuries as well as isolated injuries and are a leading cause of impairment after burn injury.1 However, there continues to be an overwhelming number of unanswered questions in nearly every facet of hand burn management. Even the issue of optimal timing for skin closure, which seemed to have been well answered, has been called into question, and recent articles suggest that even this fundamental question may require further exploration.2 Other aspects of hand burn management, including graft types (ie, full vs split thickness), postoperative positioning, use of Kirshner wires, timing for range of motion, and use of splinting, remain unresolved. The analysis of hand outcomes also has been an ongoing challenge, primarily because of the lack of validated assessment tools that correlate the extensive data one can collect on range of motion at each joint, hand strength and sensation with overall functional outcome. The purpose of the hand panel was to identify gaps in our knowledge in several different aspects of hand burn management and identify specific priorities for future research in the broad and complex domain of hand burns.