Effectiveness of Early Compression Therapy in Acute Hand Burns: A Randomized Controlled Trial

Abstract

Hand burns pose significant rehabilitation challenges. While compression therapy is well-established for chronic scar management, evidence for its application during the acute phase remains limited. This study evaluated the effectiveness of early compression therapy on edema, passive range of motion, and grip strength in acute hand burns. A randomized controlled trial was conducted at a tertiary burn centre between November 2023 and March 2025. Thirty-two adult patients (40 hands) with superficial and/or deep partial-thickness hand burns were randomly assigned to control (standard care; 16 patients, 20 hands) or intervention groups (standard care plus compression therapy at 8 mmHg; 16 patients, 20 hands). Outcomes measured at baseline and end of acute phase included hand edema, metacarpophalangeal joint passive range of motion (PROM), and grip strength. Statistical analyses included paired and independent t-tests, ANCOVA, and effect size calculations. Groups were homogeneous at baseline. The intervention group demonstrated significantly greater improvements: PROM increased 23.6±12.8° versus 8.6±16.7° (p=0.003, Cohen's d=1.00), grip strength improved 4.2±5.9 kg versus declined 0.8±5.0 kg (p=0.006, d=0.92), and edema reduced 4.2±2.9 cm versus 2.3±2.1 cm (p=0.025, d=-0.74). ANCOVA confirmed significant effects after adjusting for baseline values (all p<0.01). No adverse events occurred. Early compression therapy during acute hand burns significantly improves outcomes with large effect sizes. These findings support considering earlier initiation of compression therapy (48-72 hours post-injury) as part of acute hand burn management protocols.

Keywords: Acute phase; Burns; Compression bandages; Edema; Functional outcomes; Grip strength; Hand injuries; Randomized controlled trial; Range of motion; Rehabilitation.