Introduction: Syndactyly caused by burns to the hand is a severe and disabling sequel that limits hand function. In most cases, it results from poor scar orientation during the acute phase of the burn. This article describes the systematic technique adopted by our institution to treat this sequel, and establishes normal parameters to be investigated and surgical techniques. Methods: Between January 2009 and December 2012, 150 patients with syndactyly caused by burns to the hand underwent reconstructive surgery. The following 4 surgical steps were used to treat all patients: preparation of the dorsal flap; syndactyly release; migration and suturing of the flap to its new position; and skin graft to fill the remaining spaces. Results: There was graft survival in 100% of cases. Partial graft loss occurred 20 cases, and there were no cases of local infection. All patients recovered their hand function, including the ability to hold, and digital abduction. Conclusions: Syndactyly after burns is extremely limiting to the patient. The use of basic techniques of flaps and grafts results in successful treatment, restoring hand function compromised by the injury.Keywords: Burns/complications. Burns/rehabilitation. Hand. Syndactyly/surgery. RESUMO Introdução:A sindactilia por queimadura é uma sequela grave e incapacitante, e limita a função preensora da mão. Na maioria dos casos, é decorrente de má orientação cicatricial na fase aguda da queimadura. O objetivo deste artigo é descrever sistematização técnica adotada em nossa instituição, estabelecendo parâmetros de normalidade a serem buscados e técnicas cirúrgicas que auxiliem no tratamento. Método: No período de janeiro de 2009 a dezembro de 2012, 150 pacientes portadores de sindactilia decorrente de queimadura da mão foram submetidos a cirurgia reparadora. Em todos os pacientes, foram adotadas 4 etapas cirúrgicas: confecção do retalho dorsal; liberação da sindactilia; migração e sutura do retalho dorsal para sua nova posição interdigital; enxertia dos gaps com pele total, preenchendo os espaços remanescentes. Resultados: Em 100% dos casos houve total sobrevivência dos retalhos, com perda parcial de enxerto em 20 pacientes e nenhum caso de infecção local. Em todos os pacientes dessa série foi observada recuperação da função da mão, com capacidade de preensão e de abdução digital restauradas. Conclusões: A sindactilia pós-queimadura é uma deformidade extremamente limitante ao paciente. O emprego de técnicas básicas de retalhos e enxertos proporcionou sucesso no tratamento, com restauração da função da mão, comprometida pela lesão.Descritores: Queimaduras/complicações. Queimaduras/reabilitação. Mãos. Sindactilia/ci rurgia.

Background: This article describes the sequelae of burn injuries on the feet and surgical techniques for their treatment. This paper aims to help doctors treating burn injuries by establishing parameters of normality to be sought and effective surgical techniques for treatment. Methods: The sequelae of burn injuries on the feet were classified into 3 groups on the basis of the degree of burns and the extent of involvement of the foot's anatomic structures. Suggested surgical approaches for each group are provided. Three patients with different deforming lesions treated surgically illustrate this classification. Results: Impro vement in function was evident after using the surgical techniques in all analyzed patients. Conclusions: There are several technical options for treating sequelae of burn injuries on the feet. The plastic surgeon must perform his/her role to assist these patients and treat these lesions. The treatment of these patients starts in the acute stage of the burn injury, during which it is necessary to prepare the area for future procedures. Restoring functionality must be the goal of the surgery, especially in growing children.

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