title: Topical Negative Pressure Wound Therapy of Burned Hands: Functional Outcomes.
abstract: Extensive partial- and full-thickness burns, especially of the hands, continue to pose a surgical challenge. With improved knowledge regarding fluid balance, burn pathophysiology, and lately also given the introduction of topical negative pressure wound (TNPW) therapy, treatment regimes have changed in many burn centers. The authors evaluated the results regarding long-term outcomes of patients with partial- and full-thickness burns of the hands treated with TNPW. Over a period of 72 months, 51 patients with 80 hand burns received TNPW treatment. Medical records of all patients were reviewed retrospectively. All patients were further invited by letter, telephone, and/or email to participate in follow-up examinations. Finally, 30 patients with 47 involved hands participated in this study. Follow-up examinations were performed at a mean of 35 (range: 14-72) months postinjury. Measurements regarding the ability to completely dorsally extend the fingers and complete active fist closure showed no restrictions in 85.1 and 78.7% of cases. Mean Disabilities of the Arm, Shoulder, and Hand score among all patients was 13.8 (range: 0-35.8). Regarding the quality of the scars of the hand, 41 hands showed good quality with no signs of hypertrophic scar formation and 6 hands showed acceptable quality of scars with partial hypertrophic scar formation. In the authors' experience, TNPW therapy is a safe and effective modality to treat burns of the hand.
authors.affiliation: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital Technical University Munich, Munich, Germany.
authors.forename: Denis
authors.initials: D
authors.lastname: Ehrl
authors.affiliation: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital Technical University Munich, Munich, Germany.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Heidekrueger
authors.affiliation: Department of Plastic, Reconstructive, Hand, and Burn Surgery, StKM - Klinikum Bogenhausen, Academic Teaching Hospital Technical University Munich, Munich, Germany.
authors.forename: P Niclas
authors.initials: PN
authors.lastname: Broer
authors.affiliation: Department for Plastic Surgery and Hand Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany.
authors.forename: Holger C
authors.initials: HC
authors.lastname: Erne
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002056:Burns / Q000628:therapy*; D002921:Cicatrix / Q000517:prevention & control; D005260:Female; D006230:Hand Injuries / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D054843:Negative-Pressure Wound Therapy; D020127:Recovery of Function; D012189:Retrospective Studies; D016896:Treatment Outcome; D014945:Wound Healing