Quemaduras de la Mano: desbridamiento, injertos, cobertura y rehabilitación funcional - revisión narrativa

Resumen

Introduction: Although hand burns may involve a limited body surface area, they can cause disproportionate functional impairment through contractures, stiffness, sensory changes, and loss of dexterity. Objective: To integrate assessment criteria, wound coverage decisions, and early rehabilitation strategies to prevent long-term disability. Methods: A critical narrative review of burn referral guidelines, wound care consensus statements, and surgical and rehabilitation reviews published through October 2026. Discussion: Initial assessment should document mechanism, depth, location, perfusion, sensation, motion, and tendon or joint involvement. Selected deep wounds require timely debridement and coverage, while edema control, positioning, and occupational therapy should begin during acute care. Skin grafts, dermal substitutes, and flaps are complementary techniques selected according to wound bed, exposed structures, and functional requirements. Conclusion: Successful care is not defined by wound closure alone but by movement-oriented reconstruction, prevention of contracture, and structured multidisciplinary follow-up. Interpretation must account for heterogeneity across studies, individual anatomy, local resources, and the limitations of available evidence. Clinical decisions therefore require context-sensitive judgment rather than unsupported generalizations about the comparative superiority of a single approach.