Evaluation of hand function after early excision and skin grafting of burns versus delayed skin grafting: a randomized clinical trial.

Abstract

Thermal injury of the hand is characterized by disfigurement and deformity with marked problems because the patient is no longer able to perform the daily living activities and function at school or work. Early excision and grafting (E&G) were introduced to decrease hospital stay, hospital cost, and septic complications and to eliminate burn toxins. In this study, E&G was compared with delayed skin grafting in deep hand burns. 40 patients with deep second- and third- degree hand burns with average burn size less than 30% total body surface area (TBSA) were randomly divided into E&G group and delayed grafting group. All hands in both groups were subjected to pre and post operative program of physiotherapy. Measurement of total active motion (TAM) of each digit and grip strength was recorded pre and post operative. Hand function using Jebsen-Taylor hand function test (JTHFT) was recorded three months after operation in both groups. There were statistically significant differences in both groups regarding to TAM, hand grip strength and Jebsen-Taylor hand function test favoring the E&G group. The study concluded that early excision and skin grafting with physiotherapy gave better results than delayed grafting in terms of preservation of hand function and shortened hospital stay.