Hand Burn Injuries Research Articles

Co-design of an outcome measure for hand burn injuries

Co-design of an outcome measure for hand burn injuries

3 Hand Burn Injuries and Occupational Impairment: Impact of Burn Injuries on Return-to-Work Outcomes

3 Hand Burn Injuries and Occupational Impairment: Impact of Burn Injuries on Return-to-Work Outcomes

32 HANDFULS: A New Clinically Feasible Measure of Hand Outcome for Children with Burns and Trauma

Abstract Introduction Fine motor dexterity is important for children's normal hand function and development. In-hand manipulation (the collection and repositioning of items in the hand) and palmar workspace (functional volume in the palm) are two aspects of hand function that often become simultaneously impaired after hand trauma or burn injury. Rehabilitation emphasizes recovery of these hand functions yet few functional outcome measures address both of these constructs and even fewer are appropriate for children. Methods This study developed a new hand outcome measure to specifically assess these constructs and tested it on 192 children between the ages of 2-21. The test, called ‘HANDFULs’, uses simple instructions and inexpensive materials (i.e. marbles) shown in Figure 1. Means, standard deviations, and 95% confidence limits were estimated for children in seven age groups. Associations between age and the HANDFULs variables were examined using one-factor ANOVA. Multiple regressions were fit to test for associations between age and the HANDFULs variables after controlling for height, hand size, and hand strength. A stepwise selection procedure was then implemented, holding age into the model, to remove otherwise non-significant variables. Test-retest reliability was tested with the Shrout Fleiss Reliability Index and significance was set at p< 0.05. Results Expected normal values are reported in Figure 2 for palmar workspace volume (marbles that fit in the hand) and in-hand manipulation (collection time per marble) by age group. Age (0.16 (0.06), p=0.009), hand span (0.47 (0.09), p< 0.0001) and hand width (0.9 (0.29), p=0.003) were significantly associated with number of marbles that fit in the hand, representing palmar workspace capacity. Although hand strength and size characteristics were tested, only age (-0.02 (0.01), p=0.001) was significantly associated with the HANDFULs score of time per marble. The Intraclass Correlation Coefficient was 0.94 demonstrating excellent test-retest reliability. Conclusions This study developed a new pediatric hand outcome measure to address hand function to address a gap related to burn and trauma recovery. The measure was tested on able-bodied, noninjured children to establish validity and reliability, provide reference values for patients with injuries by age groups, and is clinically feasible to administer. Applicability of Research to Practice Outcome test for burn injured hands.

Plastic Surgery in Burn Care: A Call for Enhanced Burn Surgery Training Within Plastic Surgery Residency Programs.

A 10 year cohort of patients admitted to a verified burn unit were analyzed to assess the role of plastic surgeons in the operative management of those patients. All 3843patients were admitted during this study period. Of these, 1509 of those patients underwent surgical procedures. Plastic surgeons performed 658 operations on these patients, including acute and delayed reconstruction of hand and facial burn injuries. In this population, plastic surgeons played a critical role in acute and reconstructive burn injuries in anatomically complex areas. This series illustrates the need for plastic surgery training in burn care.

Clinical utility and validity testing of a co-designed outcome measure for hand burn injuries

IntroductionA new outcome measure for hand burn injuries was co-designed within a Participatory Action Research framework with expert clinicians and individuals with hand burn injuries. The outcome measure reviews activities which are commonly interrupted post hand burn injuries and includes 18 activities. ObjectiveThe aim of this study was to establish the clinical utility, face, and content validity of the newly developed outcome measure. MethodsThree constructs of interest were examined using study specific questionnaires from the perspectives of clinicians and individuals with hand burn injuries. Clinicians working in burns centres around Australia and New Zealand and individuals attending a burn centre within one tertiary hospital trialled the outcome measure. Upon testing the outcome measure each participant completed the questionnaire. ResultsTwenty individuals with hand burn injuries and eight clinicians trialled the outcome measure. There was 85% agreement from individuals and 100% agreement from clinicians for face validity. Content validity was tested across the domains of relevance and clarity. Individuals rated all activities and clinicians rated 16 activities as relevant. Clarity of activities was high for both participant groups (>75% agreement). Clinical utility (measured in the domains of appropriateness, accessibility, practicability, and acceptability) was high, 95% of individuals reported agreement for practicability and 100% agreement for acceptability. Clinicians reported agreement of > 87.5% for appropriateness, accessibility, practicability, and acceptability. ConclusionThe results demonstrated agreement for clinical utility, face, and content validity of the co-design outcome measure for hand burn injuries. Further validity and reliability testing is planned, including Rasch analysis.

Rehabilitation interventions after hand burn injury in adults: A systematic review

The aim of this review was to summarise the current evidence regarding the effectiveness of rehabilitation interventions in improving hand function, range of motion (ROM), hand strength, scar outcome, return to work, level of impairment/disability, level of burn knowledge and decreasing edema following hand burns in adult burn survivors. This review provides evidence-based support for the use of rehabilitation interventions for burn rehabilitation professionals. The following data sources were searched: MEDLINE, EMBASE and CINAHL from their inception up to February 2021, reference lists from all the included full-text articles were screened for additional relevant publications and monthly Google Scholar searches until December 23rd 2021 to make sure all new pertinent published articles after February 2021 would be included.Thirty-five studies were included in this review including 14 RCTs. Most of the included studies were Level 4 (46%; 16/35) and Level 2 (40%; 14/35) evidence. Only four studies were classified as Level 3 (14%; 5/35) evidence and none were considered Level 1. Most studies received a score of 5-9 (54%; 19/35) (Moderate quality). Fourteen studies received a score of ≥10 (40%; 14/35) (High quality) and only 2 studies received a score of<5 (6%; 2/35) (Low quality). Articles were categorized according to the primary outcome targeted by the intervention. Clinical recommendations on higher-level evidence interventions are presented. This review supports the clinical practice of the following interventions: 1) The use of adhesive compression wraps for patients who have increased edema to increase hand function and ROM; 2) The use of compression (adhesive compressive wrap, compression bandage or intermittent compression pump) to decrease hand edema following burn injury; 3) Participating in general rehabilitation to increase hand function and patient perceived level of disability; 4) The use of an orthosis to increase ROM and a dynamic MCP orthosis to increase hand function; 5) If available, incorporate the use of VR based rehabilitation to increase hand function and hand strength; 6) The use of paraffin to increase hand PROM; 7) The use of gels to reduce hand scar thickness; 8) The use of an education component in rehabilitation to increase the level of burn knowledge. The limitations of this study are also discussed. Further research with robust methodology is needed to investigate the potential benefits of treatment interventions included in this review.

Exploration of individuals perspectives of recovery following severe hand burn injuries

IntroductionBurns to one or both hands can impact how a person interacts with the world around them. Research regarding the specific impact of hand burn injuries and the experiences of individuals who have sustained hand burn injuries remains limited. ObjectiveThe aim of this study was to explore the lived experiences of people with severe hand burn injuries, including their return to daily activities. MethodsThis study used an interpretive description approach, incorporating 23 semi-structured interviews with people who had sustained severe hand burn injuries. ResultsA major theme, “changes over time “, was identified and reflected the progressive nature of the experience over time. This was present in all three sub-themes: physical recovery, activities of daily living recovery, and psychosocial impact. Participants described a dual process of managing the recovery of the burn injury and burn rehabilitation interventions, whilst simultaneously learning to live with their injury and finding ways to engage in their occupations to the best of their abilities. Conclusions and Implications of Key FindingsThe findings of the study suggest that burns recovery could be described in terms of performance rather than impairment and needs to be continuously monitored overtime.

792 Exoskeleton Robot Using 3-Dimensional Modeling in Burn Patient

IntroductionHands are the part of the body that are most commonly involved in burns, and the main complications are finger joint contractures and nerve injuries. Hypertrophic scarring cannot be avoided despite early management of acute hand burn injuries, and some patients may need application of an exoskeleton robot to restore hand function. To do this, it is essential to individualize the customization of the robot for each patient. Three-dimensional (3D) technology, which is widely used in the field of implants, anatomical models, and tissue fabrication, makes this goal achievable.MethodsTherefore, this report is a study on the usefulness of an exoskeleton robot using 3D technology for patients who lost bilateral hand function due to burn injury. Five burn patients with upper limb dysfunction after a flame and chemical burn injury, with resultant impairment of manual physical abilities.ResultsAfter wearing an exoskeleton robot made using 3D printing technology, the patients could handle objects effectively and satisfactorily.ConclusionsThis innovative approach provided considerable advantages in terms of customization of size and reduction in manufacturing time and costs, thereby showing great potential for use in patients with hand dysfunction after burn injury.

The investigation of the effects of occupation-based intervention on anxiety, depression, and sleep quality of subjects with hand and upper extremity burns: A randomized clinical trial

AimThis study aimed to investigate the effects of occupation-based intervention on psychological factors and sleep quality of subjects with hand and upper extremity burns. MethodsIn this randomized controlled intervention trial, a total of 20 patients were randomly assigned to one of the control group or intervention group. The control group only received traditional rehabilitation. However, the intervention group received traditional rehabilitation and Cognitive Orientation to daily Occupational Performance (CO-OP), respectively (during 18 sessions, 45 min/day in both groups). Occupational therapy sessions were held three times a week for a six-week duration. Occupational performance and satisfaction, anxiety, depression, and sleep quality were measured before the intervention and in weeks 2, 6, and 14 (follow-up) using Canadian Occupational Performance Measure, Beck Anxiety Inventory, Self-rating Depression Scale, and Pittsburgh Sleep Quality Index, respectively. FindingsThe results of the present study show that there were significant changes in all the studied variables in the two groups. However, these changes (P ≤ 0.05) were not statistically significant between these two groups. ConclusionThe results of this study show that occupation-based interventions are as effective as traditional therapeutic interventions on improving the anxiety, depression, and sleep quality in patients with hand burn injuries.

Do Psychological Factors, Pain, and Sleep Quality Correlate With Disability and Occupational Performance in Hand Burns?

Background and Objectives: Burn injuries are one of the most common traumas after traffic accidents, falls, and interpersonal violence. This study was done to investigate the correlation between psychological factors, pain, and sleep quality, and disability and occupational performance in subjects with hand and upper extremity burns. Methods: A total of 80 patients with hand and upper extremity burn injuries (16 females and 64 males) with a Mean±SD age of 39.9±10.79 years, mean burn depth (Deep Partial Thickness/ Full Thickness) of 3.42±2.66, and Mean±SD burns extent 1.06±0.24 participated in this non-experimental cross-sectional study using a non-probability sampling method. Their psychological disorders were measured using the Beck Anxiety Disorder Scale and the Self-Rating Depression Scale. The pain was assessed using the Visual Analogue Scale, sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI), disability was assessed using the Shortened Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, level of independence in daily living activity was measured by the Modified Barthel Index, and occupational performance was measured by the Canadian Occupational Performance Measure (COPM). Results: Psychological factors, pain, and sleep quality were significantly correlated with disability and occupational performance. The regression models explained up to 34.4% of the variance for disability outcome and 12.4% for occupational performance. By assessing the correlation between the psychological disorders, pain, and sleep quality, and disability and occupational performance in these patients, we found that sleep quality was the strongest contributing factor Followed by PSQI. Conclusion: Sleep quality is one of the important factors affecting the occupational performance of patients with hand and upper extremity burns injury that should be considered by therapists.

Paediatric Burns of the Hand: Our Experience Over Three Years.

Background and aimContact burn injuries to the hand are common in the paediatric population, with the most common aetiology involving touching hot surfaces in the household. The hand is also often involved in paediatric scald injuries. The aim of this study was to determine the different presentations of hand burn injuries and analyse the outcomes in the paediatric population at Royal Aberdeen Children’s Hospital (RACH).MethodsAnonymised clinic data for paediatric patients with hand burns presenting to our burn centre from 2017 to 2020 were retrospectively reviewed. A total of 52 patients (65 affected hands) were included in the study. Clinic letters stored on NHS Grampian’s electronic patient record system were reviewed for burn surface area, time to healing, management measures including medications prescribed and sequelae of the burn injury.ResultsThe average patient age was three years and four months old. There were 31 male patients and 21 female patients. Paediatric hand burns were most commonly confined to the palm only, followed by the fingers only. Contact with a hob was the most common aetiology, followed by scald burns. The average time to healing was 10 days (range 2-28 days). No correlation was found between length of stay on initial hospital admission and time to complete healing. A total of 86.5% (n=45) of patients were managed with dressings and 13.5% (n=7) of patients underwent surgical management. Of these seven patients, four had surgical debridement of burn tissue, washout, and dressing, and the remaining three had an excision and grafting with thick split-thickness skin grafts. Of these three patients, one patient had to undergo secondary reconstruction with a full-thickness skin graft.ConclusionIt has been found that most patients in this study completely healed with primarily conservative measures of dressing care and regular check-ups. Isolated hand burns in the paediatric population present a low rate of sequelae and palms are the most common area of burn injury in this demographic.

Socioeconomic and Comorbid Factors Associated With Frostbite Injury in the United States.

Frostbite largely affects the extremities and often results in long-term disability due to amputation. More regions are experiencing extremes in temperature which increases the risk of frostbite injury. The aim of this study was to detail social and comorbid factors associated with frostbite injury compared to isolated hand or foot burns. We used the National Inpatient Sample from 2016 to 2018 to identify admissions included in this study. Weighted incidence and multivariable analysis assessed characteristics and outcomes of frostbite and isolated hand or foot burn injury. In the United States, the estimated incidence of frostbite injury in those aged 15 and older was 0.95 per 100,000 persons and 4.44 per 100,000 persons with isolated hand and foot burns. Homelessness, mental health disorder, drug or alcohol abuse, and peripheral vascular disease were all associated with the risk of frostbite injury when compared to burn injury. We found that other insurance was associated with amputation following burn injury, while black race and homelessness were associated with amputation during a nonelective primary admission following frostbite injury. The differing risk factors associated with early amputation in frostbite and burn patients warrant a multicenter study including burn centers in North America.

Outcomes for Hand Burns Treated With Autologous Skin Cell Suspension in 20% TBSA and Smaller Injuries.

In order to address the confounder of TBSA on burn outcomes, we sought to analyze our experience with the use of autologous skin cell suspensions (ASCS) in a cohort of subjects with hand burns whose TBSA totaled 20% or less. We hypothesized that the use of ASCS in conjunction with 2:1 meshed autograft for the treatment of hand burn injuries would provide comparable outcomes to hand burns treated with sheet or minimally meshed autograft alone. A retrospective review was conducted for all deep partial and full-thickness hand burns treated with split-thickness autograft (STAG) at our urban verified burn center between April 2018 and September 2020. The exclusion criterion was a TBSA greater than 20%. The cohorts were those subjects treated with ASCS in combination with STAG (ASCS(+)) vs those treated with STAG alone (ASCS(-)). All ASCS(+) subjects were treated with 2:1 meshed STAG and ASCS overspray while all ASCS(-) subjects had 1:1, piecrust, or unmeshed sheet graft alone. Outcomes measured included demographics, time to wound closure, proportion returning to work (RTW), and length of time to RTW. Mann-Whitney U test was used for comparisons of continuous variables and Fisher's exact test for categorical variables. Values are reported as medians and 25th and 75th interquartile ranges. Fifty-one subjects fit the study criteria (ASCS(+) n = 31, ASCS(-) n = 20). The ASCS(+) group was significantly older than the ASCS(-) cohort (44 [32-54] vs 32 years [27.5-37], P = .009) with larger %TBSA burns (15% [9.5-17] vs 2% [1-4], P < .0001) and larger size hand burns (190 [120-349.5] vs 126 cm2 [73.5-182], P = .015). Comparable results were seen between ASCS(+) and ASCS(-), respectively, for time to wound closure (9 [7-13] vs 11.5 days [6.75-14], P = .63), proportion RTW (61% vs 70%, P = .56), and days for RTW among those returning (35 [28.5-57] vs 33 [20.25-59], P = .52). The ASCS(+) group had two graft infections with no reoperations, while ASCS(-) had one infection with one reoperation. No subjects in either group had a dermal substitute placed. Despite being significantly older, having larger hand wounds, and larger overall wounds within the parameters of the study criteria, patients with 20% TBSA burns or smaller whose hand burns were treated with 2:1 mesh and ASCS overspray had comparable time to wound closure, proportion of RTW, and time to return to work as subjects treated with 1:1 or piecrust meshed STAG. Our group plans to follow this work with scar assessments for a more granular picture of pliability and reconstructive needs.

A Cross-sectional Survey of Health Professionals Across Australia and New Zealand to Determine What Outcome Measures Are Important From a Clinical Perspective Post Hand Burn Injury.

Outcome measures are used in healthcare to evaluate clinical practice, measure efficiencies and to determine the quality of health care provided. The Burns Trauma Rehabilitation: Allied Health Practice Guidelines advocates for the collection of outcome measures post burn injuries across different time points. These guidelines recommend multiple tools which can be utilized when measuring outcomes post burn injuries. The aim of this study was to gather information from specialist clinicians regarding their clinical practice and the outcome measurement tools used post hand burn injuries. This cross-sectional study used a survey design to collect data at one given point in time across a sample population. A total of 43 clinical specialists allied health professionals responded to the survey. Respondents indicated that their patients considered hand dexterity was the most important outcome. Three months post burn injury was the most common timepoint for measurement (n = 31, 72.1%) followed by six months (n = 27, 62.8%). Patient report of hand function (n = 42, 97.7%) and observation (n = 41, 95.3%) were the most frequently reported assessment methods. The Jamar Dynamometer (n = 40, 93%), goniometer (n = 39, 90.7%) and pinch gauge (n = 36, 83.7) were the most frequency cited assessment tools. The findings of this study suggest that clinical specialist allied health collect some outcome measures in their routine practice. Based on the respondent's perceptions of barriers when using outcome measures and lack of reliable/validated tools to measure hand burn outcomes, there is a need for further studies in this area.

116 Cross-cultural Translation, Adaptation and Validation of the Burnt Hand Outcome Tool (BHOT) from English to French Canadian

Abstract Introduction The Burnt Hand Outcome Tool (BHOT) is a comprehensive patient-reported outcome measure to assess the multiple impacts of hand burn injuries. However, this tool is currently only available in English. The aim of this study was to create a French Canadian, cross-cultural translation and adaptation of the BHOT and to investigate its reliability and validity. Methods The BHOT was translated and culturally adapted following published good practice principles for patient-reported outcome measures. The steps included translation to French, backward translation, expert committee review, and cognitive debriefing with 5 adults having burn injuries excluding their hands. Then, 39 adults with hand burn injuries tested the pre-final French version of the questionnaire (BHOT-F) in order to determine its clinimetric properties. Reliability was investigated by determining the Cronbach’s alpha internal consistency coefficient. Construct convergent validity was assessed by comparing the BHOT-F to the shortened version of the Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Content validity was evaluated based on comments extracted from interviews with the participants and a committee of burn care experts. Results The BHOT-F was modified during the adaption process to ensure its clarity. Cronbach’s alpha was 0.94 indicating excellent internal consistency and was &amp;gt; 0.75 for all sub-domains. The BHOT-F and the QuickDASH were strongly correlated (rs = .86; p &amp;lt; 0.01). Content validity was deemed satisfying. Conclusions The French-Canadian version of the BHOT is a reliable and valid tool that can confidently be used in clinical practice for adults with hand burn injuries and compared to data generated with Anglophone populations.

Cross-cultural translation, adaptation and validation of the Burnt Hand Outcome Tool (BHOT) from English to French Canadian

BackgroundThe Burnt Hand Outcome Tool (BHOT) is a comprehensive tool assessing the multiple impacts of hand burn injuries which makes it essential to burn care practice, but is currently only available in English. ObjectivesTo create a French-Canadian cross-cultural adaptation of the BHOT and to assess its content and construct convergent validity. MethodsThe BHOT was translated and culturally adapted according to evidence-based principles for patient-reported outcome measures. The steps included translation to French (BHOT-F), backward translation, expert committee review, and cognitive debriefing with 5 adult participants. A pre-final version of the BHOT-F was then administered to 39 adult participants with hand burn injuries to assess construct convergent validity using the shortened Disabilities of the Arm, Shoulder and Hand questionnaire (QuickDASH). Content validity was evaluated based on comments from the expert committee and participant burn survivors. ResultsThe BHOT-F was modified during the adaption process to ensure its clarity. The Cronbach’s alpha value of 0.935 demonstrates the excellent internal consistency of the BHOT-F. The BHOT-F and the QuickDASH were strongly correlated (p < 0.01). Content validity was deemed satisfactory and recommendations are reported for future research. ConclusionsThe BHOT-F demonstrates adequate clinimetric properties to be used in clinical practice.

Range of Motion Exercises Effect during and after Hydrotherapy on Patients Burned Hand Function and Pain Intensity: A Comparative Study

Hand burn injuries can result in devastating functional impairments and hamper quality of life. One of the rehabilitation program components is hydrotherapy, which help in cleaning the burn surface, debriding wounds, facilitating the separation of eschar, facilitating physiotherapy, and improving patients’ comfort. This study aimed to evaluate range of motion exercises effect during and after hydrotherapy on patients burned hand function and pain intensity. A quasi-experimental comparative research design was conducted on three equal group of 15 adult patients having second degree burn of the hand (superficial and deep partial-thickness burns). Three tools were used for collecting the data: Tool I: Burn patient Assessment interview schedule. Tool II: Burned Hand functional assessment. Tool III: Pain Visual Analogue scale (VAS). Significant improvement was noticed among the three groups subjects in relation wrist and finger joint measurements, manual muscle testing, functional ability of the hand, and pain intensity. Hydrotherapy is an effective, alternative intervention that can be used by care providers as a non-pharmacological method in most burn centers.

A systematic review to investigate outcome tools currently in use for those with hand burns, and mapping psychometric properties of outcome measures

BackgroundSevere burn injuries to the hand impact multiple domains of function and participation. Measurement of outcomes after hand burn injuries is multifaceted and is influenced by several variables. ObjectiveThe aim of this systematic review was to review outcome measures reported in studies used to measure outcomes after severe hand burn injuries; and to critically evaluate the reliability, validity and clinical utility of each hand assessment tool identified from the literature to determine suitability for use with the burn’s population. Data sourcesA search of the published literature using electronic data bases MEDLINE, CINAHL, PEDro, OT seeker and PubMed was undertaken. Studies were included if they reported assessment tools and outcome measures used to determine hand function after severe burn injuries; were published in English and available in their full-length. Studies were excluded if they were related to a group under 18 years of age. ResultsThirty-four papers were included in this systematic review. A total of 25 outcome measures were confirmed for inclusion in this paper and each underwent further evaluation to identify their psychometric properties. LimitationsA factor which could cause bias in this systematic review was the search was restricted to English language journals therefore excluding any primary papers in other languages. Mapping of the outcome measures to the ICF was conducted by the primary author which may give rise to bias however a member checking was conducted in order to remove this bias. ConclusionsThis review established that no one outcome measure meets all the psychometric properties of validity, reliability and responsiveness Systematic Review Registration Number ProsperoCRD42018085059.

Randomized Controlled Trial of Compression Interventions for Managing Hand Burn Edema, as Measured by Bioimpedance Spectroscopy.

Compression, a common treatment of choice for the management of edema, is one intervention that is applied with little objective understanding of the optimal parameters of application or efficacy in acute burn wounds. The aim of this study was to determine the effectiveness of different methods of compression for the management of hand edema following burn injury. The primary hypothesis tested was that in acute hand burn injury, the application of cohesive bandage will reduce edema faster than a generic compression glove. It is a randomized controlled study of 100 patients presenting with hand burn injury. Compression was randomized to one of the three methods of application: 1) spiral application of Coban to fingers, figure of eight to hand and wrist; 2) pinch application of Coban to fingers, spiral application to hand and wrist; or 3) a generic compression glove (control condition). Bioimpedance spectroscopy was used to measure hand volumes. Hand and wrist range of movement, pain scores, and QuickDASH were recorded. One hundred patients (68 males) demonstrated significant reductions in hand volumes, using all compression methods. Both methods of applying Coban resulted in significantly greater reductions in edema compared to the generic compression glove. Notwithstanding compression method, all range of movement measures improved, with significant improvement in thumb opposition (P = .046), hand span (P = .020), and wrist flexion (P = .020). QuickDASH decreased between sessions (P < .001). Different methods of applying Coban are superior to generic compression gloves for managing acute hand burn edema.

Bioimpedance Spectroscopy Is a Valid and Reliable Measure of Edema Following Hand Burn Injury (Part 1-Method Validation).

The assessment of swelling following burn injury is complicated by the presence of wounds and dressings and due to patients experiencing significant pain and impaired movement. There remains a lack of sensitive objective measures for edema in patients presenting with hand burn injury. Bioimpedance spectroscopy (BIS) is a measure of body composition that has been demonstrated by our group to be reliable for measuring whole body and limb edema during resuscitation and to be sensitive to edema changes within healing wounds. The aim of this study was to determine the reliability and validity of BIS as a measure of edema following hand burn injury specifically. One hundred patients presenting with burn injury including a portion of a hand were recruited to this trial. Repeated measures of the hand were recorded using a novel application of BIS and in parallel with water displacement volumetry (WDV). The results were analyzed using mixed-effects regressions. Paired repeated measures were obtained for 195 hands, using four electrode configurations. BIS demonstrated high reliability in measuring hand BIS-Intraclass Correlation Coefficient 0.995 to 0.999 (95% CI 0.992-1.000) and sensitivity-Minimum Detectable Difference 0.74 to 3.86 Ω (0.09-0.48 Ω/cm). A strong correlation was shown with WDV, Pearson's r = -0.831 to -0.798 (P < .001). BIS is a sensitive and reliable measure of edema following acute hand burn injury.