Comprehensive Rehabilitation Management for Children With Burn Injury on Hand

摘要

Background: Children are of the most susceptible groups for burn injuries, and hand injuries are prevailing among all sites of injuries. Due to the unique role of hands in children’s normal development, pediatric hand burn injuries may result in permanent disabilities that severely affect the functioning and quality of life of the child and the family. Therefore, other than proper wound care and timely surgery, rehabilitation management for children with burn injury on hand is essential. Objective: This presentation aims to propose a comprehensive rehabilitation management strategy for children with burn injuries on hands. Materials and Methods: Pediatric cases admitted to our university rehabilitation clinic with bilateral hand injuries due to second-degree burn are presented as case series. Tailor-made intervention regime was provided for each case. New methods of pressure therapy intervention was introduced, including innovative products of the Smart Pressure Monitored Suit and the Smart Pressure Monitored Padding, which were developed and patented by our research team. Splints were provided and monitored. Functional activities, parent education, and counseling, as well as home programs were also delivered. The state of preservation of the pressure intervention products, the splint condition and the rehabilitation progress of the children were monitored on a regular basis. The treatment outcomes are presented by comparing the pre- and post-intervention photos and functioning of the patients. Results: Cases with pediatric bilateral hand injuries demonstrated satisfactory recovery on both hand functions and scar appearances. Several features have been identified from the cases as key elements in successful management of pediatric burnt hand. The proper adoption of the concept of pressure therapy played an important role, and the therapists should not limited pressure intervention to pressure garment only. Proper splinting of hands prevented and corrected contracture and deformation effectively. Engaging children into age-appropriate activities should be also considered. Suitable environment that promotes participation and reduces psychological stress should be established. Moreover, the psychosocial well-being of the children and the caregiver should be addressed in order to achieve maximum compliance to the intervention regime. Finally, regular long-term follow-ups guarantee the effectiveness of the rehabilitation intervention. Conclusions: To achieve the optimal functional recovery that enables participation and engagement, individualized, comprehensive and early rehabilitation management is advocated. Rehabilitation on pediatric burns is a long-term process that requires not only collaboration and understanding among different parties but also persistent effort.