Treating Hand Burns on Children

Children love to explore, often reaching for and touching unfamiliar objects.  Unfortunately—since scalds and burns rank among the most frequent accidents for toddlers and younger children—this curiosity can result in injuries.  When the hands are involved in a burn injury, the skin, soft tissue, tendon and sometimes muscle can be damaged.

While the hands represent a relatively small wound area in a burn, the wound can cause significant disability if healing is not carefully managed. Shriners Hospitals for Children-Boston, a leader in treating hand burns in children, specializes in surgery and reconstruction of hands that maximizes both function and appearance.

The burned hand is challenging to repair and heal because of its intricate anatomy and functions.  Severe hand burns can, without intervention, develop tightened skin, raised scars and functional limitations. 

The process of keeping a burned hand functional starts with proper wound management, caregiver education and positioning/splinting if needed.  If surgical intervention is required, early excision of burned areas with skin grafting may produce the best result.  As the hands heal, proper splinting and rehabilitation are key for a good functional outcome.

Positioning and Splinting

Proper positioning of the hands can prevent them from contracting (which incapacitates the hand’s ability to open and close) during the healing process. Because this kind of contracting is much more difficult to repair later, it’s important to begin treatment as soon as possible after injury.

Splinting is sometimes used to position the hand for healing, as well as positioning the hand as the scar matures to prevent contractures or loss of function.  The progression of splinting usually begins with the splint being used at all times, and then often diminishes to night use only.  Splints are continuously adjusted to accommodate the dressing, and maximize soft tissue stretch.

Occupational Therapy and Physical Therapy

Occupational and/or Physical therapy can make a significant difference in hand function following a burn injury. At Shriners Hospital for Children-Boston, an occupational or physical therapist will often assess the patient within 24 hours of the injury to determine mobility and function.  Therapy treatment sessions are designed to return the hand to maximum functional ability. It is important to be treated by a burn specialist who understands all the possible complications that could arise.

The care required to manage a hand burn does not always mean that a child has to be admitted to the hospital. Many hand burns can be treated on an outpatient basis, with only occasional admissions for surgery or other procedures.

A major role of the occupational or physical therapist is to educate caregivers so they are able to complete wound or scar management at home and follow up in clinic on an as needed basis. This education includes how to wrap or secure splints, scar massage and how to apply pressure garments for scar management.  The therapist will create a home exercise program that is individually tailored to increase hand function and promote purposeful use.  The focus of hand therapy is to increase independence with daily activities and the child’s ability to complete developmentally appropriate tasks.

To learn more about hand burn injury treatment, or other types of treatment at Shriners-Boston, we encourage you to reach out by calling us at 617-722-3000.

If you’d like to support the children who receive treatment at Shriners-Boston, please consider making a donation to the hospital.