Management of the Acutely Burned Hand

Pan, Brian S.; Vu, Anthony T.; Yakuboff, Kevin P.

doi:10.1016/j.jhsa.2015.02.033

Cited by 36 publications

(21 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Nas queimaduras em que há perda de revestimento cutâneo, faz-se necessária a aplicação de enxerto cutâneo, podendo ser do tipo parcial ou total, de acordo com suas características. [13,23] …”

Section: Discussionunclassified

“…Se esta condição não for tratada desde o início, pode ocorrer o enrijecimento articular e formação de aderências tendinosas no membro. O tratamento consiste em curativos diários com agentes antibacterianos, curativos oclusivos em posição funcional, elevação do membro e exercícios diários, que servem principalmente para tratar o edema que causa as aderências [1,[10][11][12][13][14]. As condutas locais iniciais foram sintetizadas na Figura 2.…”

Section: Classificação Da Gravidade Da Lesãounclassified

“…Além disso, pode-se associar à sulfadiazina de prata o nitrato de cério a 2,2%, o qual aumenta a ação antibacteriana e a resposta imunológica. A eficiência desses agentes tópicos locais requer uma troca regular dos curativos [1,[21][22][23].…”

Section: Agentes Tópicosunclassified

See 2 more Smart Citations

Atendimento inicial às queimaduras de mão: revisão da literatura

Silva

Ferdinando

Garbin

et al. 2015

Sci Med

View full text Add to dashboard Cite

Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. RESUMOObjetivos: Abordar, por meio de uma revisão da literatura, o manejo das queimaduras de mão, com ênfase nos cuidados iniciais. Métodos: No período entre fevereiro e julho de 2015, foram revisados 30 artigos selecionados nas bases de dados MedLine/PubMed, LILACS, SciELO e Google Acadêmico, inclusos tanto os de língua inglesa quanto portuguesa, publicados nos últimos 10 anos e que correspondessem aos seguintes descritores: queimadura de mão; ferimento de mão; tratamento agudo; tratamento primário; e seus correspondentes em inglês. Resultados: É apresentada a classificação das queimaduras conforme a profundidade, extensão e fatores agravantes. São abordadas as condutas iniciais que evitam complicações como mão em garra, síndrome compartimental e infecções. Os procedimentos iniciais incluem curativos oclusivos, escarotomia, fasciotomia, abertura do túnel do carpo, seguidos por curativos com agentes antimicrobianos tópicos, desbridamento e enxertos. São discutidos aspectos controversos sobre o momento mais indicado para a intervenção cirúrgica, caso esta seja necessária. Conclusões: A correta abordagem inicial da queimadura de mão poderá evitar sequelas irreversíveis. O manejo adequado na queimadura de mão inclui desde a avaliação clinica inicial da área queimada por um médico generalista à realização de condutas precoces com o objetivo de evitar a perda de função do membro e futuras reconstruções desnecessárias. A elevada incidência desse tipo de queimadura também acentua a relevância de uma conduta adequada. DESCRITORES: mãos; ferimentos e lesões; queimaduras; tratamento primário. ABSTRACT Aims:To address, through a literature review, the management of hand burns, with emphasis on the initial care. Methods: Between February and July 2015, 30 articles selected in the databases Medline/PubMed, LILACS, SciELO and Google Scholar were reviewed. Both the English and Portuguese languages were included in the search. Selected articles were published in the last 10 years and matched the following descriptors: hand burn; hand injury; acute treatment; primary treatment; and their counterparts in Portuguese. Results: Classification of burns is displayed, including depth, extent and aggravating factors. The initial management that avoid complications such as claw hand, compartment syndrome and infection is addressed. Early procedures include occlusive dressings, escharotomy, fasciotomy, and carpal tunnel opening, followed by dressings with topical antimicrobial agents, debridement and grafting. Controversial aspects are discussed on the most appropriate time for surgical intervention, if it is necessary. Conclusions: The correct early approach to hand burns can prevent irreversible consequences. The appropriate management on hand burns includes since the initial clinical evaluation of the burned ...

show abstract

Section: Discussionunclassified

Section: Classificação Da Gravidade Da Lesãounclassified

See 1 more Smart Citation

Atendimento inicial às queimaduras de mão: revisão da literatura

Silva

Ferdinando

Garbin

et al. 2015

Sci Med

View full text Add to dashboard Cite

show abstract

“…Burns surgeons use clinical examination by visual estimation of burn size and depth as the primary method of evaluation in a patient with severe burns, and as the method that determines expected outcomes and therefore management. 85 Although some surgeons consider clinical examination the gold-standard of patient assessment, 86 there is evidence that visual estimations of depth are often inaccurate when compared with histologically determined depth, with expert surgeons unable to determine depth in up to 35% of burns. [87][88][89] These methods have been validated but have limitations in reliability and as a result lead to inaccurate estimations, with recent research showing that nonhealth care-trained people are better at estimating burn size than expert surgeons.…”

Section: The Clinical Assessment Of Patients With Severe Burnsmentioning

confidence: 99%

A Critical Update of the Assessment and Acute Management of Patients with Severe Burns

Lang

Zhao²,

Kim

et al. 2019

Advances in Wound Care

View full text Add to dashboard Cite

Burns are debilitating, life threatening, and difficult to assess and manage. Recent advances in assessment and management have occurred since a comprehensive review of the care of patients with severe burns was last published, which may influence research and clinical practice. Recent Advances: Recent advances have occurred in the understanding of burn pathophysiology, which has led to the identification of potential biomarkers of burn severity, such as protein C. There is new evidence about the potential superiority of natural colloids over crystalloids during fluid resuscitation, and new evidence about components of initial and perioperative management, including an improved understanding of pain following burns. Critical Issues: The limitations of the clinical examination highlight the need for imaging and biomarkers to assist in estimations of burn severity. Fluid resuscitation reduces mortality, although there is conjecture over the ideal method. The subsequent perioperative period is associated with significant morbidity and the evidence for preventing and treating pain, infection, and fluid overload while maximizing wound healing potential is described. Future Directions: Promising developments are ongoing in imaging technology, histopathology, biomarkers, and wound healing adjuncts such as hyperbaric oxygen therapy, topical negative pressure therapy, stem cell treatments, and skin substitutes. The greatest benefit from further research on management of patients with burns would most likely be derived from the elucidation of optimal fluid resuscitation protocols, pain management protocols, and surgical techniques from randomized controlled trials.

show abstract

“…Aggressive early treatment of hand burns is critical and involves a combination of debridement, autografting, edema prophylaxis, early mobilization, splinting and optimal hand rehabilitation [7, 8]. A thorough initial assessment of the type of burn mechanism and burn depth should be accomplished in order to guide the need for surgical therapy.…”

Section: Introductionmentioning

confidence: 99%

Scar Management of the Burned Hand

2017

View full text Add to dashboard Cite

Unimpaired hand function is critical in almost all activities of daily living. Burn injury can result in hypertrophic scar formation that can lead to debilitating functional deficits and poor aesthetic outcomes. Initial algorithms of acute burn management involve early debridement and skin grafting and early mobilization to prevent formation of hypertrophic scarring and ultimately digit contractures. While non-operative modalities in the early phase of scar maturation are critical to minimize hypertrophic scar formation, surgical management is often indicated in order to restore hand function. The essential tenant of operative scar management is release of tension, which can often be achieved through local tissue rearrangement. Laser therapy has emerged as a central pillar of subsequent scar rehabilitation with several modalities that address scar texture, color, pruritis and thickness. These can be utilized in conjunction with local corticosteroid treatment and other emerging modalities to modulate the scar and achieve optimal hand function. These treatment tools provide an effective resource for the reconstructive surgeon to treat hypertrophic hand scars.

show abstract

Management of the Acutely Burned Hand

Cited by 36 publications

References 18 publications

Atendimento inicial às queimaduras de mão: revisão da literatura

Atendimento inicial às queimaduras de mão: revisão da literatura

A Critical Update of the Assessment and Acute Management of Patients with Severe Burns

Scar Management of the Burned Hand

Contact Info

Product

Resources

About