Late effects of burns Discussion
Late effects of burns of the hands take many forms. All patients who have
recovered from deep partial thickness or full thickness burns will have a
permanent sensation of tightness or stiffness at the extremes of affected
range of motion, regardless of measured range of motion. This may be
improved but not cured with surgical procedures. Other more obvious
problems include joint contractures, unstable scars, numbness, weakness,
hygiene problems, nail growth deformities, amputations and grotesque
visible deformities. Therapy is helpful in early recovery, but is not
adequate as an isolated intervention for established problems. Surgery is
indicated for a variety of problems. Because no surgery can be expected to
restore a normal appearance, indications for surgery are not cosmetic.
Surgical options include soft tissue release and resurfacing (with grafts,
flaps or free tissue transfer), arthrodesis, and amputation. In general,
because of the physiology of burn healing, surgery for burn reconstruction
is both more technically demanding and associated with a higher
complication rate than for other types of reconstruction.
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