The burned hand

Small burns and superficial burns are the most common injuries admitted to burn centres around the world. In most centres, they account for more than 80-90 % of all admissions [1]. Thanks to prevention programs and the increasing awareness of society regarding burn injuries, the incidence of massive, life threatening burns is declining in the developed countries. However, they continue to be a public health concern throughout the world, especially in middle and low-income countries [2]. Many of them, however, represent major burns by the American Burn Association criteria because they usually are deep burns of hands, face, feet, perineum, and major joints [3] (Table 11.1). Deep minor burns, either deep partial thickness or full thickness burns, have significant morbidity in terms of time to healing, infective complications and subsequent scarring (Fig. 11.1). Conservative management leading to spontaneous healing usually involves prolonged and painful dressing changes and the resultant scar is invariably hypertrophic leading to cosmetic and functional debility. Thus an early surgical approach that tries to preserve dermis and achieve wound healing is preferred.