What is the therapy cost of a burn to the palm?

Stephanie Wicks1, Elizabeth Anderson1, Madeleine Jacques2, Cheri Templeton1, John Harvey3

1 Physiotherapist, The Children’s Hospital at Westmead, Locked bag 4001, Westmead, NSW, 2145    stephanie.wicks@health.nsw.gov.au
2 Transitional Nurse Practitioner, The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145
3 Department Head, Paediatric Burns Unit, The Children’s Hospital at Westmead, Locked Bag 4001 Westmead, NSW 2145

Palmar burns usually represent a total body surface area (TBSA) of <1% but are often more challenging to rehabilitate than burns of a greater TSBA. These burns also represent some of the most common burns amongst the paediatric population. Young children explore and interact with their environment using their hands. In doing so, they are at risk of contact with heat sources and sustaining thermal injuries. Scars involving the palm are uniquely difficult to manage. Contractile forces of the developing scar result in a rapidly forming contracture, which can have catastrophic effects on the function of the developing hand. Initiation of an intensive therapy program from the onset of a palmar burn is essential in optimising functional and cosmetic outcomes. Casting the palm in end of range extension, during the healing phase, is vital to allow skin to heal in a lengthened position. In burns that fail to heal within 14 days, continuation of splinting beyond healing ensures maintenance of full palmar range of motion. This project will investigate the average estimated therapy cost for a senior burns therapist to manage a palmar burn requiring scar management. A randomised sample of palmar burns that have completed a scar management treatment regime at a paediatric burn unit will be reviewed and the average cost per burn calculated. The results of this study will allow the average annual therapy cost for the unit to manage these small but clinically significant burns to be quantified.

Key Words

Palm Burn, Physiotherapy, Occupational Therapy, Splinting, Hand Therapy, Contracture


Stephanie is a Senior Physiotherapist with over 13 years of experience as a paediatric physiotherapist at The Children’s Hospital at Westmead. She has worked exclusively as a burns therapist for the past 6 years and has an interest in optimising the functional outcome of paediatric hand burns

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