There is however no place for the prophylactic administration of antibiotics or treating swab results. Their use should be reserved for clinical infection as indicated by cellulitis and pyrexia. Prevention of swelling and preservation of motion are crucial to the long-term outcome. A burned hand should be kept elevated and movement encouraged. Burns, which are of significant size, that have not healed within three weeks should be referred for a specialist opinion.
Healing is likely to be prolonged and accompanied by significant contracture.
The scars will be of poor quality, being prone to frequent breakdown after minor trauma and exposure to a multitude of household chemicals and food- stuffs. Surgical management Escharotomy is often performed poorly, there being either a failure to release the full length of the burn or poor planning of incisions with damage to nerves or exposure of structures. Incisions on fingers should be mid-axial to avoid subsequent loss of motion due to contracture. These need not be along both sides of a finger and ideally should avoid vulnerable surfaces such as the ulnar border of the hand. Incisions on the hand should be planned carefully without going straight across natural creases but avoiding narrow skin flaps.