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The Effect of Hand Burns on Quality of Life in Children

Dodd, Andrew R. MD*; Nelson-Mooney, Kate RN; Greenhalgh, David G. MD; Beckett, Laurel A. PhD; Li, Yueju MS; Palmieri, Tina L. MD

Journal of Burn Care & Research: May-June 2010 - Volume 31 - Issue 3 - p 414-422
doi: 10.1097/BCR.0b013e3181db5295
Original Articles

There is limited data regarding the long-term outcomes for children with hand burns. The objective of this study was to prospectively document recovery after burn injury using a validated health outcomes burn questionnaire for infants, children, and adolescents. A single center prospective study was conducted on consecutive children aged 0 to 4 years and 5 to 18 years comparing outcomes between children with and without hand burns. Age specific American Burn Association/Shriners Hospitals for Children Burn Outcomes Questionnaires were administered at admission, first clinic after discharge, 3, 6, 12, 18, and 24 months after injury. One hundred eighty-one consecutive patients were enrolled in the study. Demographic, injury, and survey outcome data were available for 145 patients for at least 24 months after injury. Children with hand burns had significantly longer hospitalization, intensive care unit days, ventilator days, and TBSA burns. Initial Burn Outcomes Questionnaire scores for children with hand burns were significantly lower than controls and children with burns not involving the hand. For ages 0 to 4 years and 5 to 18 years, only the domain specific to upper extremity function was significantly decreased between the groups over the entire study period. Despite severe injury, children with hand burns have continued improvement in quality of life for at least 2 years after injury. The presence of a hand burn in the context of large TBSA burn is a marker of more severe acute illness and predicts increased resource utilization. Rehabilitative efforts after upper extremity injury should continue to target both physical function and the psychosocial impact of burn injury.

From the *Division of Burn Surgery, Department of Surgery, University of California, Davis; †Department of Surgery, Shriners Hospital for Children Northern California, Sacramento; and ‡Department of Biostatistics, University of California, Davis School of Medicine, Sacramento.

Supported by Shriners Hospital for Children Grant 9115.

The authors have no commercial associations or financial interests in any of the products, devices, or drugs mentioned in this article.

Address correspondence to Tina L. Palmieri, MD, Division of Burn Surgery, University of California-Davis and, Shriners Hospital for Children-Northern California, 2425 Stockton Blvd., Sacramento, California 95817.

© 2010 The American Burn Association