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Current State on the Management of Acute Hand Burns: Results from a Survey of the United States Burn Centers
Siddhi A. Shockey, University of Pittsburgh School of Medicine
Hilary Y. Liu, University of Pittsburgh School of Medicine
Mario Alessandri-Bonetti, MD, Department of Plastic Surgery, University of Pittsburgh Medical Center
Alain C. Corcos, MD, FACS, Department of Surgery, University of Pittsburgh Medical Center
Guy M. Stofman, MD, Department of Plastic Surgery, University of Pittsburgh Medical Center
Jenny A. Ziembicki, MD, Department of Surgery, University of Pittsburgh Medical Center
Francesco M. Egro, MBChB, MSc, MRCS, Department of Plastic Surgery, University of Pittsburgh Medical Center
University of Pittsburgh School of Medicine
2023-01-31
Presenter: Siddhi Shockey
Affidavit:
I certify that the material proposed for presentation in this abstract has not been published in any scientific journal or previously presented at a major meeting.
Director Name: Francesco M. Egro, MBChB, MSc, MRCS
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Hand
Background
Hand burns have a significant impact on patients in their everyday life. Recently, new protocols and technologies, such as dermal substitutes, have been introduced for the treatment of hand burns. In this cross-sectional study, we aim to investigate the current standard-of-care adopted for hand burn management and the role of dermal substitutes in treatment.
Methods
A cross-sectional study was conducted in December 2022. A 9-question survey related to acute hand burn management was sent to 64 directors of American Burn Association (ABA)-verified burn centers.
Results
Hand burns are managed in 87.5% of burn centers by burn surgeons only, and 12.5% by either burn or plastic surgeons. For treatment of superficial partial thickness hand burns, directors preferred a non-operative approach (87.5%). All participants chose a single-stage reconstruction involving excision and skin grafting for deep partial thickness hand burns. For full thickness hand burns, single-stage excision and skin grafting was preferred (75%). However, some preferred a two-stage approach including the application of dermal substitutes or allografts (12.5%). Among dermal templates, Novosorb-BTM (28.6%), Integra (20%) and ReCell (20%) were preferred. The clinical reasoning for choosing one specific dermal substitute was the surgeon's preference (50%), cost (37.5%), or evidence-based superiority (12.5%).
Conclusion
Excision and skin grafting as a one-stage procedure remains the standard-of-care for hand burns. Future randomized controlled trials should measure the real benefit of dermal regenerative templates in improving aesthetic and functional hand burn outcomes.
