title: Study on Surgical Management of Post Burn Hand Deformities.
abstract: BACKGROUND
  Functionality of the hands is the major determinants of the quality of life in burns survivors. If contractures or scarring affect the dominant hand, as they do on most occasions, the vocation and there by the economic status of the patient suffer.
  
  
  OBJECTIVE
  The aim of this study is to evaluate the different surgical procedures for resurfacing after release of post-burn hand contractures in terms of functional recovery and aesthetic outcome.
  
  
  METHODS
  It's a prospective, non-randomised study of 50 patients admitted and undergoing surgical reconstructive procedures for post burn hand contractures in our plastic surgery department.
  
  
  METHODS
  Resurfacing procedures were done according to type of contracture with individualisation for each case. All cases were followed up with physiotherapy and splinting advices. Functional and aesthetic outcome and recurrence of contracture for each procedure was noted at 6 months.
  
  
  RESULTS
  Forty seven percent of the cases were reconstructed with skin grafting, 30% cases with Z plasties and 23% with flap coverage. Split thickness skin grafts (STSG) and full thickness graft (FTSG) reconstructed cases had good recovery of joint mobility in 43% and 75% of cases respectively. Reconstructive procedures were aesthetically acceptable to the patients in 63%, 75% and 94% of STSG, FTSG and Z plasty cases respectively. Recurrence was seen in 17% of STSG done cases.
  
  
  CONCLUSIONS
  Most of the cases can be resurfaced with skin grafting and few cases have clear indication for flap coverage which needs to be planned and executed cautiously. Z plasties with proper planning gives maximum length gain with no donor morbidity as other procedures. Postoperative physiotherapy and splinting is must for better outcome in all cases.
authors.affiliation: Resident, Department of Plastic Surgery Medical College , Kolkata, India .
authors.forename: Nonavinakere Prabhakera
authors.initials: NP
authors.lastname: Sunil
authors.affiliation: Professor and Head of Department, Department of Plastic Surgery, Medical College , Kolkata, India .
authors.forename: Firdos
authors.initials: F
authors.lastname: Ahmed
authors.affiliation: Associate Professor, Department of Plastic Surgery, Medical College , Kolkata, India .
authors.forename: Prabir Kumar
authors.initials: PK
authors.lastname: Jash
authors.affiliation: Assistant Professor, Department of Plastic Surgery, Medical College , Kolkata, India .
authors.forename: Madhumita
authors.initials: M
authors.lastname: Gupta
authors.affiliation: Resident, Department of Plastic Surgery, Medical College , Kolkata, India .
authors.forename: Santanu
authors.initials: S
authors.lastname: Suba
keywords: Hand contractures; Hand reconstruction; Skin grafting; Z plasty