Abstract
Background. Post-burn scar contractures of the hand hold a significant place among burn sequelae. Hand burns constitute 85–89% of all burn injuries. Post-burn scar deformities of the hand are a leading cause of disability among burn victims, accounting for 48.5% of cases of disability. Objective. To conduct a comparative analysis of the effectiveness of various methods for treating hand burns, with a focus on the prevention of scar formation. Materials and methods. The study involved 62 patients with IIIA-IIIB degree hand burns. Three main groups were formed based on the primary treatment method: Group I (n=16) — early necrotomy with autodermoplasty for IIIB degree burns (within 5 days); Group II (n=25) — delayed autodermoplasty for IIIB degree burns (on days 21–27); Group III (n=21) — conservative treatment for IIIA degree burns. Each group was further divided into subgroup A (receiving a collagenase-based enzymatic agent + silicone gel) and subgroup B (receiving no anti-scar therapy). Outcomes were assessed at 6 months and included biomechanical parameters (elasticity, hydration, TEWL), the POSAS scale, and the need for reconstructive surgery. Results. The obtained data indicate that the strategy of early active surgical treatment of deep hand burns, combined with the comprehensive use of a collagenase-based enzymatic agent and silicone gel, promotes the formation of scars with biomechanical properties closest to those of healthy skin and reduces the need for reconstructive surgery. Conclusion. The study established that a strategy of early active surgical treatment for deep hand burns, followed by comprehensive anti-scar therapy, is the most effective approach. This method significantly promotes the formation of functionally adequate scars and minimizes the need for reconstructive surgery. The positive effect of conservative anti-scar therapy was confirmed regardless of the initial burn depth and surgical tactics, whereas the absence of such therapy was associated with the poorest long-term outcomes.