Randomised control trial of compression interventions for managing hand burn edema, as measured by bioimpedance spectroscopy

Introduction: Compression, a common treatment of choice for the management of edema, is one intervention which is applied with little objective understanding of the optimal parameters of application or efficacy in acute burn wounds.

Aim: 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: in acute hand burn injury, application of cohesive bandage will reduce edema faster than a generic compression glove.

Methods: A randomized control study of 100 patients presenting with hand burn injury. Compression was randomized to one of 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 (BIS) was used to measure hand volumes. Hand and wrist range of movement, pain scores and QuickDASH were recorded.

Results: 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 ROM measures improved, with significant improvement in thumb opposition (p=0.046), hand span (p=0.020) and wrist flexion (p=0.020). QuickDASH decreased between sessions (p<0.001).

Conclusion: Different methods of applying Coban are superior to generic compression gloves for managing acute hand burn edema.

Keywords: Hand burn injury; bioimpedance spectroscopy; compression; edema; hand volume.