Rethinking treatment strategies for second-degree palmar burns in adults: A ten-year retrospective outcome analysis at a major burn center

TL;DR

This study examines treatment outcomes for second-degree palmar burns in adults, finding that healing time and care needs vary based on burn depth and extent.

Contribution

The study provides a ten-year retrospective analysis of palmar burn treatment outcomes, highlighting the impact of burn depth and extent on recovery.

Findings

Deep second-degree palmar burns healed significantly slower and required more inpatient care compared to superficial burns.

Non-isolated burns were associated with longer healing times, worse functional outcomes, and more frequent inpatient treatment.

Aesthetic outcomes did not differ significantly between burn types, but functional impairments were comparable.

Abstract

Hand burns are common, affecting 80 % of burn cases and 40 % of hospitalized patients. Although the palmar surface constitutes only 1.2 % of total body surface area, burns in this region can severely impair hand function. Currently, no standardized treatment guidelines exist. This study analyzes functional and aesthetic outcomes in adult patients with conservatively treated partial-thickness palmar burns.

A retrospective, single-center cohort study was conducted on adult patients with second-degree palmar burns treated between 2012 and 2022. Functional outcomes were assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and aesthetic outcomes were evaluated based on skin discoloration, scarring, and patient-reported concerns.

Of 316 cases, 57 (18.0 %) met inclusion criteria. Deep burns were more often treated inpatient (60.0 % vs. 24.4 %, p = 0.033) and healed significantly slower (23.87 ± 5.44 vs. 8.41 ± 3.57 days, p < 0.001). Functional impairments were comparable between groups (p > 0.195), though QuickDASH scores were slightly worse in deep burns (p = 0.312). Aesthetic outcomes did not differ significantly. Non-isolated burns were linked to longer healing (p < 0.001), worse QuickDASH scores (p = 0.015), and more frequent inpatient care (p = 0.012).

Deep burns showed significantly longer healing times but no major differences in functional or aesthetic outcomes compared to superficial burns. Non-isolated burns were associated with poorer functional outcomes and longer recovery, suggesting that burn extent impacts healing and rehabilitation needs. These findings support structured follow-up and rehabilitation strategies, emphasizing the need for further research to refine treatment protocols.

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