Burn injuries to the hands often lead to joint contractures and scarring, resulting in significant functional and cosmetic challenges that can cause disability and psychological distress. Changes in the hand’s natural shape and architecture can disrupt daily activities and diminish aesthetic appeal, complicating reintegration into social and work environments. Although these injuries typically do not impact survival rates, the functional restoration and aesthetic rehabilitation of burnt hands are crucial. This study systematically evaluated the effectiveness of various rehabilitation interventions designed to prevent disability after hand burn injuries. Interventions included splinting, scar management, pressure garments, paraffin wax therapy, hands-free gaming devices, therapeutic ultrasound, physical therapy, and occupational therapy, aimed at enhancing cosmetic and functional outcomes. Additionally, psychosocial interventions such as counseling and cognitive-behavioral therapy were explored to address psychological issues, including depression, anxiety, and post-traumatic stress disorder, among affected individuals. A comprehensive literature search of four medical databases, PubMed, The Cochrane Library, Medline, and Hinari, yielded 268 articles, from which 14 relevant studies were selected for final screening. These included randomized controlled trials (RCTs) and non-randomized controlled trials, providing insights into effective techniques and positive outcomes. However, the studies also highlighted concerns regarding the duration and intensity of rehabilitation programs, as well as issues related to sample size. In conclusion, while existing rehabilitation measures are vital for improving long-term outcomes following hand burn injuries, further research is needed to address these limitations comprehensively.

Hand burn injuries, Rehabilitation interventions, Functional outcomes, psychological outcomes, Disability prevention, Cognitive-behavioral therapy.

Hand burn injuries can significantly affect a person’s ability to function and mental health. Every year, there are around 4860 incidents of hand burn injuries in the United States. Burn injuries, particularly those that impact the hands, can cause serious impairments such as reduced hand dexterity, loss of feeling, and restricted range of motion.[1,2] These impairments can significantly impact an individual’s ability to perform activities of daily living and work-related tasks, leading to disability and poor quality of life. Hand burn injuries can have a profound psychological impact on an individual. The disfigurement and visible scars caused by burns can cause body image dissatisfaction, social anxiety, and psychological distress.[3] The psychological consequences of hand burn injuries can further exacerbate functional limitations, creating a cycle of disability and psychological distress.[4]

This systematic review holds several important implications for clinical practice, research, and policy development. Firstly, to increase the knowledge on effective rehabilitation interventions for hand burn injury patients, this review can contribute to evidence-based clinical decision-making. The findings of this research can help medical professionals treating hand burn injuries by applying the most effective rehabilitation techniques and tailoring interventions to each patient’s needs. Improved rehabilitation methods can lead to better patient outcomes, including greater functional recovery and improved quality of life.[5,6] Secondly, this review can contribute to the overall improvement of patient outcomes and quality of life. This review can guide the development of comprehensive rehabilitation programs for individuals with hand burn injuries by identifying effective rehabilitation interventions.

Researchers and policymakers can benefit from this systematic review. Policymakers can use the findings of this review to adjust healthcare regulations and resource distribution, ensuring that people with hand burn injuries have access to appropriate rehabilitation services. Scholars can identify gaps in the literature and focus on areas that require further research, such as the cost-effectiveness of different approaches and the long-term effects of rehabilitation interventions. To encourage functional recovery and lessen psychological suffering in people with hand burn injuries, this study attempts to evaluate the efficacy of rehabilitation methods. Policymakers and researchers in the area can benefit from the review’s conclusions, which can also improve clinical procedures and patient outcomes. This review has the potential to positively impact the lives of individuals who are affected by these injuries by addressing the physical and psychological consequences of hand burn injuries. “This article was previously presented as a meeting abstract at the 18th International Handscon on March 12, 2023.”

In this systematic review, a population, intervention, comparison, and outcome (PICO) was formulated to provide a structured framework. Keywords are hand burn, hand injury, rehabilitation, intervention, disability, and psychological distress. MESH terms: “Burns”, “Hand Injuries”, “Rehabilitation”, “Disability Evaluation”, “Stress”, “Psychological”. Before the article screening and data extraction process, inclusion and exclusion criteria were established, as illustrated in the following table.

A comprehensive search was conducted across electronic databases, including PubMed, MEDLINE, Embase, and PsycINFO. Additional sources included reference lists of relevant articles, conference proceedings, and grey literature. Two independent reviewers screened the titles and abstracts of retrieved articles against inclusion and exclusion criteria. Article that potentially meets the eligibility criteria selected for full-text assessment. Full-text articles of selected studies were assessed independently by two reviewers. The reviewers determined which studies to include based on predefined criteria. Any discrepancies between reviewers are resolved through discussion or with a third reviewer.

The risk of bias in this study was assessed using appropriate methods, such as the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Newcastle-Ottawa Scale for nonrandomized studies. Two reviewers independently assessed the risk of bias, and any disagreements were resolved with a third reviewer. The quality and methodological rigor of the included studies were assessed using appropriate quality rating methods for each research type. A narrative synthesis that considers the similarities and differences across the included research summarizes the findings. A discussion of interventions, results, and their effects on psychological distress and impairment may be included in the synthesis. To guarantee transparent reporting and repeatability, the systematic review reported adhering to the recommended reporting items for systematic reviews and meta-analyses (PRISMA) standards.

In our systematic review, we found that rehabilitation interventions following hand burn injuries have a positive impact on preventing disability. The included studies consistently demonstrated that early and comprehensive rehabilitation programs, such as a combination of physical therapy, occupational therapy, and psychological support, were effective in reducing disability and increasing functional outcomes.[5,7] These interventions focused on restoring range of motion, strength, and dexterity, as well as facilitating the reintegration of individuals into their daily activities and work. Rehabilitation interventions play an important role in preventing long-term disability by addressing impairments and promoting adaptive methods.

Our review also found that rehabilitative therapies can significantly reduce psychological suffering in people with hand burn injuries. This demographic is prone to psychological suffering, such as anxiety, sadness, and post-traumatic stress disorder (PTSD).[8,9] The included studies demonstrated that psychosocial interventions, such as cognitive-behavioral therapy (CBT), counseling, and support groups, were effective in reducing psychological distress and improving overall well-being.[10] By addressing the psychological impact of hand burn injuries, rehabilitation interventions contribute to preventing long-term psychological distress.[2,9]

The strengths of the included studies in our review included rigorous methodologies, including RCTs and systematic data collection. Numerous studies used established outcome measures and had sufficient sample sizes, which improved the validity and reliability of the results. A thorough examination of the subject was also made possible by the research’s inclusion of a wide variety of rehabilitation methods. The included studies had notable limitations. There was variation in the treatments and outcome measures used, making direct comparisons difficult. The duration and intensity of rehabilitation programs differed between studies, making it difficult to define effective intervention parameters. Most of the research had relatively short follow-up periods, making it difficult to assess long-term outcomes. Numerous studies have small sample sizes, which may limit the extent to which their results can be generalized. Future studies should address these constraints to produce more reliable findings.

This study has significant implications for the treatment of hand burn injuries in clinical settings. The need for comprehensive rehabilitation strategies should be acknowledged by medical professionals who treat patients with hand burns.[6] Early initiation of rehabilitation, involving a multidisciplinary team, should be prioritized to maximize functional recovery and prevent disability. Physical and occupational therapy should focus on restoring hand function, range of motion, and strength, and on providing education on self-management strategies.[6,11] Psychosocial interventions, such as counseling and support groups, should be integrated to address the psychological impact of the injury and facilitate emotional well-being.

Even though rehabilitative therapies have been found to have a favourable impact, several areas still need further research. First, additional investigation is required to ascertain the best time, length, and level of therapy after hand burn injuries. To direct therapeutic practice, standardized procedures must be created. To evaluate the long-term impacts of rehabilitative therapies on psychological well-being and disability prevention, long-term follow-up studies are crucial.[12] Future research should also examine the cost-effectiveness of these treatments to inform resource allocation decisions. Lastly, to ensure that rehabilitation therapies are tailored to their needs, research should focus on diverse groups, such as children and older adults.[13] Several limitations to this systematic study should be considered. First, it was challenging to make direct comparisons since the included studies’ rehabilitation techniques and result metrics varied widely. Second, most of the studies had relatively short follow-up periods, making it difficult to assess long-term effects. Third, a few of the included studies had small sample sizes, which may have affected the generalizability of the results.

Rehabilitation therapies are successful in preventing impairment and lowering psychological distress, as per this systematic study, after hand burn injury. Comprehensive programs that enhance functional outcomes and general well-being include occupational therapy, physical therapy, and psychological treatment. These therapies reduce long-term impairment, enhance quality of life, and help people reintegrate into everyday activities and employment. To ascertain the ideal time, length, intensity, cost-effectiveness, and particular needs of certain groups, further study is required.

Not reported

The authors have no financial relationships with any organizations that might have an interest in the submitted work.

Corresponding Author:
Fatima Khurshid
Department of Radiation Oncology
Shifa International Hospitals Limited, Islamabad, Pakistan
Email: fatimakhurshid61@yahoo.com

Co-Authors:
Qadees Younas
Department of Surgical ICU
ABS Teaching Hospital, Punjab, Pakistan

Bikram Thapa
Department of Emergency Medicine
Croydon University Hospital, UK

Zahid Iqbal Bhatti
Department of Plastic Surgery
ABS Teaching Hospital, Punjab, Pakistan

Qadees Younas contributed to the study design and conceptualization. Bikram Thapa was responsible for manuscript writing. Zahid Iqbal Bhatti conducted the literature review. Fatima Khurshid performed the critical revision and drafting of the work.

The authors declare no conflicts of interest.

None

https://doi.org/10.63096/medtigo3062348

Younas Q, Thapa B, Bhatti ZI, Khurshid F. Rehabilitation Interventions for Hand Burn Injuries: A Systematic Review of Functional and Psychological Outcomes. medtigo J Med. 2025;3(4):e3062348. doi:10.63096/medtigo3062348 Crossref