An evaluation of the necessity for physiotherapy intervention for patients with isolated hand/forearm burns treated with Biobrane®

Brad Schmitt1,2, Kathy Stiller1, Kathryn Heath2, Dr John Greenwood2, Thomas Sullivan3

1Physiotherapy Department, Royal Adelaide Hospital, Adelaide, Australia, 2Adult Burns Service, Royal Adelaide Hospital, Adelaide, Australia, 3Data Management and Analysis Centre, Discipline of Public Health, University of Adelaide., Adelaide, Australia

Despite being relatively small, hand burns can have major implications because of their effect on function, appearance and health-related quality of life. Patients with isolated hand burn injuries managed with Biobrane® have shown (Williams et al 2012) rapid recovery in all outcomes, with normal or near-normal values achieved within 2 weeks to 1 month post-injury. Given that the recovery of patients with isolated hand burns that were able to be managed with Biobrane® was so rapid and the amount of physiotherapy intervention required was relatively low, it raises the question of whether any physiotherapy intervention is actually required.

The study design was a randomised controlled trial with single blinding. Following consent, participants were randomly allocated to a usual treatment or no treatment group. Outcome measures included Michigan Hand Questionnaire (MHQ), grip strength and total active movement (TAM). MHQ was taken at baseline, 1,2 ,4 and 12 weeks post-operatively. Grip strength and TAM were taken at 1,2 and 4 weeks post-operatively.

29 patients (17 male, 12 female) were recruited (Ave. age = 39.2 yrs, Ave. TBSA 1.49%), 15 were randomised into the treatment group and 14 into the no treatment group. Baseline MHQ scores were 97.6 (n=29). Week 12 MHQ scores were treatment 95.1 (n=9) and control 95.1 (n=7). Average grip strength at week 4 was treatment 32.3kg (n=12) and control 33.0kg (n=7). Further data analysis will be conducted to compare groups.

Early analysis suggests minimal difference in recovery, irrespective of physiotherapy input for isolated hand burns treated with Biobrane®.

Senior Physiotherapist at the Royal Adelaide Hospital

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