It’s not just swelling… Why you should pay close attention to edema of the hand

Vita TU, Project Manager and Occupational Therapist,

Sunshine Social Welfare Foundation

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You’ve probably seen this kind of hand before. It’s been a while since the patient’s injury, but his hands still look swollen. The patient also complains that the swelling causes stiffness when making finger movements. You immediately identify edema. Should you be worried? Is it serious? Will it eventually dissipate by itself?

The fact is, whether it occurs in the acute phase or much later during the rehabilitation phase, edema should not be taken lightly because if it is left untreated, edema can cause serious and long-lasting damage to hand functions. In this post, we’ll explain why edema is serious and why therapists should never overlook or underestimate its impact when dealing with burned hand.

What is edema?

Edema is a normal response to burn injury. The inflammatory response post-burn will cause limbs to swell. Edema will affect both injured and non-injured areas. According to literature, up to 50% of the tissue fluid after edema will be distributed in the non-burned area [1].

After the injury, the permeability of the microvessels throughout the body will increase, causing fluids and proteins to seep out into the tissues, resulting in systemic edema. Accumulation of fluids in tissues will increase negative pressure in the interstitial space, compressing blood vessels and reducing blood circulation. The compression of blood vessels can even result in tissue necrosis.

At the same time, proteins accumulate in tissues, causing fibrosis or thickening of tissues. When fibrin starts to accumulate in the various structures of the hands, such as the tendons, tendon sheaths, joint capsules, synovial membranes and fascia layers, it will cause adhesion between structures, which becomes dense fibrous tissue, and then scars. Persiste