Correction of hand deformities after burns

Abstract

Hand burns can lead to deformities even after successful primary healing. They are the most common cause of skin contracture involving the hand. This review article discusses ways to correct claw deformity, flexion contracture in the palm and finger, and web space contracture, which are post-burn hand deformities commonly encountered in clinical practice. Loss of skin is the end result in many cases of hand deformities after burns. Therefore, reinforcing the lost skin is the principle of corrective surgery. Even if the skin is thicker than the full-thickness skin, it will engraft if damage to the tissue and blood vessels of the recipient is minimized. The thicker the skin, the less re-contraction and growth occur. The foot is an ideal donor site for skin grafts on the hand. In particular, the instep or the area below the malleolar is a very good donor site. The first web space of the hand is very important for hand function, and it must be reconstructed with Z-plasty, a skin graft, and a free flap step by step according to the degree of contraction.