# Dorsal Multi-Digit Heat-Press Injury: Staged Full-Thickness Skin Grafting with Range of Motion Tracking

## TL;DR

A staged skin grafting approach with motion tracking successfully treated a severe hand injury from a heat press, preserving full finger movement.

## Contribution

A novel staged reconstruction protocol with ROM tracking for dorsal multi-digit heat-press injuries is presented.

## Key findings

- Staged full-thickness skin grafting with artificial dermis placement led to successful tissue reconstruction.
- Serial joint-specific range of motion tracking improved outcome interpretation and comparability.
- Long-term follow-up showed no hypertrophic scarring and full functional recovery of the hand.

## Abstract

Background and Clinical Significance: Heat-press injuries of the hand can cause deceptively deep, progressive tissue damage, and dorsal multi-digit involvement carries a high risk of joint stiffness and scar contracture. Case Presentation: A 58-year-old left-hand-dominant woman sustained a dorsal heat-press injury affecting the left index to small fingers; we performed staged reconstruction with tangential debridement and artificial dermis placement (Day 9) followed by full-thickness skin grafting (FTSG) from the right infraclavicular region (Day 23), with supervised rehabilitation from Day 15 and active ROM resumed on postoperative day (POD) 6 after FTSG. Conclusions: At long-term follow-up (POD 821 after FTSG; ≈2.2 years), the reconstructed digits showed no hypertrophic scarring and achieved full finger motion with full fist formation; serial joint-specific active ROM tracking may enhance interpretability and comparability of outcomes in this uncommon but functionally critical injury pattern.