Development of an integrative algorithm for the treatment of various stages of full-thickness burns of the first commissure of the hand

- The literature about the treatment of burns of the first web space is reviewed.
- An algorithm for the different stages of burns of the first web space is proposed.
- We relate each degree and stage of the burn with a specific treatment.

Burns of the first commissure of the hand can evolve into an adduction contracture of the thumb. We decided to conduct a review of the existing literature on the treatment of full-thickness burns of the first commissure in order to develop a treatment algorithm that integrates the various currently available procedures. A search of the existing literature was conducted, focusing on the treatment of a burn of the first commissure in its chronic and acute phases. A total of 29 relevant articles were selected; 24 focused exclusively on the chronic contracture stage, while 3 focused exclusively on the acute burn stage, and 2 articles studied both stages. A therapeutic algorithm for full-thickness burns of the first commissure of the hand was developed. With this algorithm we sought to relate each degree and stage of the burn with a treatment.