الفهرس 
ANATOMY OF THE HANDOnly 14 pages are availabe for public view
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Abstract
Through comparing between early and delayed excision and grafting of hand burn by measuring ROM and hand grip function, this study have reached to the conclusion that early excision of burn of the hand and autografting is better than conservative late grafting. This is overviewed in terms of better restoration of the function of the hand and avoiding the possible complications from tissue contracture. Early excision of burned hand with prompt physiotherapy leads to significant and faster regain of hand function regarding to total active motion of digits, hand grip strength and daily living activities. It shortens the hospital stay and time required to return to normal use of hand.
By early excision and grafting, functional recovery may be achieved within 8 weeks, whereas in the conventional method, desloughing alone requires at least 2 weeks, and the shortest possible time for full healing is therefore will exceed 8 weeks by far. It also virtually abolishes pain and morbidity. The optimum time for early excision should be before the fourth day. It is well known that the first reaction phase of burn ends on the third day after injury. Oedema starts to subside, depth diagnosis at this point is reliable and infection is limited. Excision is better carried without a tourniquet, since bleeding is the main element allowing separation of viable from nonviable tissues.
Clinical evaluation, measuring the ROM combined with patient satisfaction was deemed to be significant in assessing the return of function. This study reached that unless there are special contraindications early tangential excision for deep dermal or full thickness burn of the dorsum of the hands should be encouraged at the appropriate time. The primary advantages are rapid healing time, a satisfactory range of movement, and a better cosmetic appearance with a nearly normal feel of the dorsum of the grafted hand.
Although early excision is better mode of treatment, still conventional method is superior in minimizing graft loss as well as minimizing the sacrifice of normal tissues in between the burns during excision.