PMC1501118_01
Handle of screwdriver (a) and screwdriver tip (b) used by electrician described in text. Note that fingerprint melted into the handle and that the tip of the screwdriver has been rounded.
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F1
Right hand (dorsum [a]; palmar aspect [b]) of patient at time of arrival. Outside referral center had treated the hand with silver sulfadiazine before transfer.
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F2
The hand and digits were pale in color and dry on the dorsum, suggesting deep, partial-thickness burns (Fig 2).
Right hand after 48 hours of subatmospheric pressure treatment (a). Close-up of digits (b).
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F3
The clinical impression at this time was that the hand burn had not progressed but had stabilized and had minimal edema (Fig 3).
Right hand at approximately 5 weeks after injury. Digits in extension (a). Digits in flexion (b) and close-up of digits (c). Note the severity of injury to the fingernails, suggesting a deep burn to the hand.
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F4
At approximately 4 weeks, his skin not only was functional but also had an excellent cosmetic result (Fig 4).
Appearance of the upper extremity at approximately 5 weeks (a). Close-up of the skin of the dorsum of the hand (b) as compared to a close-up of the skin of the shoulder (c). Note that the skin of the shoulder, which appeared more superficially burned than the hand on arrival, now has more discoloration than the skin of the hand.
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F5
In addition, the skin on the hand appeared more normal with less hyperemia than the skin of the shoulder, despite the fact that the hand had received the deepest burn consistent with the mechanism of surgery (Fig 5).