Gauze Wrapping for Post-Burn Hand Management: Clinical Considerations for Burn Therapists
- Shiou-Han Yang
- Sep 4
- 3 min read
Updated: Sep 6
Shiou-Han Yang, Senior Occupational Therapist
Taipei Rehabilitation Center, Sunshine Social Welfare Foundation
Managing hand edema and hypertrophic scarring after burns is a critical part of the rehabilitation process. Pressure therapy, when applied appropriately, can help minimize swelling, support tissue remodeling, and prevent long-term contractures. While Coban is a commonly used material for compression wrapping, it may not always be accessible due to cost or availability, especially in low-resource settings.
To explore the underlying mechanisms of edema in more depth, see our article It’s not just swelling… Why you should pay close attention to edema of the hand.
This is where gauze wrapping for post-burn hand management becomes a practical and effective alternative. In our latest instructional video (embedded below), we demonstrate a step-by-step method for using gauze and elastic bandage to wrap the fingers and palm. In this blog post, we explore the clinical reasoning behind this method, including when to use it, what to watch out for, and how to optimize its safety and effectiveness.
When to Use Gauze Wrapping for Post-Burn Hand Management
Gauze wrapping can be used in both the early and intermediate stages of burn rehabilitation. It is especially beneficial when:
The patient has fragile or healing skin that may not tolerate stronger compression materials like Coban
Coban may not be financially feasible for the patient or clinic, and in some settings it may be difficult to procure or unavailable locally
For more on assessing scar readiness and maintaining skin integrity during therapy, see our related post: Pressure therapy for burn scars: What are the considerations for scar stability? Balancing scar protection and scar control
Please note that unlike Coban, which can be used to wrap both the fingers and the palm using different tape widths (typically 1-inch for fingers and 2-inch for the palm), gauze is applied only to the fingers. A standard elastic bandage—sometimes referred to as a crepe elastic bandage—is then used to continue the wrap from the palm, over the wrist, and if needed, all the way up the forearm.
Contraindications and Precautions
As with Coban, gauze wrapping has specific contraindications and precautions that must be considered. Before applying:
Ensure all open wounds are cleaned, medicated, and securely dressed. Gauze used for compression should never come into direct contact with an open wound.
For detailed discussion on applying pressure over wounds, refer to Pressure Garments and Wounds: To Use or Not to Use?.
Assess circulation carefully. If the fingers turn pale, cold, or numb, or if capillary refill is delayed, the wrap should be removed immediately and re-applied with less tension.
Watch for patient discomfort. Sensory changes, areas with fragile or unstable scar surface may require a lighter wrap or an alternative strategy.
Avoid friction points, especially at the end of the elastic bandage where pressure may concentrate.
Key Application Considerations
Always leave the fingertips exposed to monitor circulation.
Secure gauze strips with tape to avoid unraveling during use.
Position fixation points away from scarred or newly healed areas, especially over bony prominences or joint creases.
Do not wrap the elastic bandage too high over the metacarpophalangeal (MP) joints. When combining the use of elastic bandage to wrap the palm (and continue over the wrist and forearm), be careful that the bandage doesn’t exceed the MP joints, as this can limit finger abduction and restrict functional hand movement.
If additional pressure is needed between fingers, consider adding a folded gauze pad between the digits and securing it externally with tape.
Common Mistakes to Avoid
Wrapping too tightly, which can impair blood flow
Applying gauze directly over wounds without dressings
Using too short or narrow strips that unravel easily
Ignoring finger size and hand shape variations during preparation
Allowing bunching or folding of gauze, which may create discomfort
Watch the Full Video Demonstration
To see the full method in action, we invite you to watch our detailed demonstration video below.
Conclusion
Gauze wrapping is a versatile and affordable technique for therapists working in burn care, particularly when Coban or custom pressure garments are unavailable. When applied thoughtfully, it provides gentle, adjustable compression that supports healing and function.
Comments