Abstract
We devised a new method for the treatment of burned fingers using negativepressure dressing (NPD) together with early therapeutic finger exercise, and achieved good results.
A 38-year-old man was injured when his right fingers were caught in a heat press. The index and small fingers received second degree burns, and the middle and ring fingers received third degree burns.
After adequate debridement, using clean techniques, the wounds were covered with a hydrophilic polyurethane sponge. A drainage tube was placed on top of the sponge, and the whole region was covered with a film dressing. Then the hand was placed in a commercially available, gas sterilized, sealable bag. The mouth of the sealed bag was fixed to the forearm with film dressing to ensure a tight seal. The tube was connected to an aspirator equipped in the ward, and a negative pressure of -15 to -17 kPa was maintained during rest periods. During therapeutic exercise of the fingers, aspiration was stopped and the negative pressure was reduced to allow space in the sealed bag for the fingers to move freely.
Eight weeks after the start of NPD, adequate granulation and wound regression were achieved, and NPD was terminated. Two weeks after termination of NPD, the wound was almost epithelialized. At the last follow-up 17 weeks after injury, TAM was 97.4% in the middle finger and 94.7% in the ring finger.
The method we used allows therapeutic finger exercise at the initiation of NPD, which probably kept joint contracture and scar contracture to a minimum.
