A closed burn wound can still leave a hand that barely moves.

In this episode of Plastics in Practice, we review how to recognize threatened circulation, reassess burn depth, and protect hand function while the wound heals.

Key takeaways:
• After immediate trauma priorities, remove rings and assess circulation, sensation and movement.
• Cool fingers, worsening sensation, delayed refill or deteriorating Doppler signals need urgent burn surgical assessment. Do not wait for pulse loss.
• Reassess depth and healing progress; a potentially deep hand burn needs early specialist input.
• Typical dorsal burns need wrist extension, knuckle flexion, straight interphalangeal joints and an open thumb web. Palmar injuries may need a different position.
• Combine edema control with supervised movement when the wound and deeper structures permit; protect vulnerable grafts and tendons.
• Follow finger flexion, extension and first web opening alongside wound closure.

This content is for educational purposes only and is not medical advice.

The podcast audio is generated with Google NotebookLM using AI voices. These are synthetic discussion voices, not clinicians or accounts of their personal experience.

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#HandBurns #BurnCare #HandSurgery #BurnRehabilitation #PlasticsInPractice

References:
1. American Burn Association. Guidelines for Burn Patient Referral. https://www.ameriburn.org/burn-care-team/resources/guidelines-for-burn-patient-referral
2. NSW Agency for Clinical Innovation. Escharotomy for burn patients: a guide for clinicians. 2025. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0003/162633/ACI-Escharotomy-for-Burn-Patients.pdf
3. NSW Agency for Clinical Innovation. Burn physiotherapy and occupational therapy: clinical practice guide. 2025. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0018/236151/ACI-Burn-physiotherapy-and-occupational-therapy-guide.pdf