The comparison of two methods of treatment evaluating complications and deficiency of functions of hands after deep partial skin thickness hand burns

Kęstutis Maslauskas, Rytis Rimdeika, Jolita Rapolienė¹, Žilvinas Saladžinskas¹, Donatas Samsanavičius, Vygintas Kaikaris

Department of Plastic and Reconstructive Surgery, Kaunas University of Medicine, ¹Kaunas University of Medicine, Lithuania

Key words: hand burns; hand injuries; skin grafting.

Summary. Hands actively participate in daily activities of a human; therefore, hands are the most vulnerable parts of the human body. People injure hands so often because namely hands are in the closest position to the dangerous equipment. According to the data of various authors, the injuries of hands and fingers make even 30–75% of all industrial traumas, and burns of hands account for about 6% of all traumas of hands.

The aim of the study was to compare the effectiveness of active surgical treatment method with conservative treatment method, applied for the treatment of deep dermal partial skin thickness burns of the hands, wrists, and forearms of distal third.

Materials and methods. A total of 49 patients with burned hands participated in the perspective study of random sample (totally 79 hands). All these patients were treated in the Department of Plastic and Reconstructive Surgery, Hospital of Kaunas University of Medicine, during the period of 2001–2005. The patients were assessed after 3, 6, and 12 months.

Results. Applying conservative method of treatment of deep partial skin thickness burns, the frequency of infectious complications was increased. In order to evaluate the state of scar, we applied the scale of Vancouver and analyzed the pigmentation of a scar, its height, flexibility, and color. After statistical analysis had been performed, we determined that more changes of skin were seen in the group, which received active surgical treatment (P<0.05).

Conclusions. Statistically significantly fewer complications were in the group of active surgical treatment in the early (fewer infectious complications, smaller area of unnaturalized autograft) and in the late (scars were less rough, with less changes of pigmentation) postoperative periods.

Correspondence to K. Maslauskas, Department of Plastic and Reconstructive Surgery, Kaunas University of Medicine, Eivenių 2, 50009 Kaunas, Lithuania. E-mail: m.kestas@lycos.com

Received 19 July 2007, accepted 23 September 2008