"Supersplint": a new dynamic combination splint for the burned hand.

Dynamic splinting for the burned hand is used worldwide. We previously presented a home hand therapy program. This program included a series of dynamic splints made by the occupational therapist for daily use by the patient. The "supersplint" evolved from the need to reduce the time required to manufacture the splints for the home therapy program; it also reduced patient-therapist sessions in the occupational therapy unit. The supersplint provides active-resistive movements of the fingers and thumb. As range of motion progresses, resistance can be increased to strengthen muscles and tendons. The supersplint provides tendon gliding, helps control edema, prevents muscle disuse, prevents skin and capsular contracture, minimizes complications, and helps prevent deformities. The patient uses the supersplint daily as part of an occupational therapy program that includes activities of daily living, prevention of shoulder hand syndrome, and scar therapy (including pressure garments).

The ping-pong ball microphone: facilitating speech for a patient with hand burns and a tracheostomy.

Patients who have sustained thermal injuries may require tracheostomies as a result of facial burns; these operations may also be required after prolonged intubation for smoke inhalation injury or respiratory failure. For a patient with a temporary tracheostomy, speech may be achieved by occluding the opening of the tracheostomy cannula with the tip of a finger, thereby directing airflow through the vocal cords and allowing phonation to be produced. However, some patients who also have hand burns may not be able to cover the opening of the tube because of the injuries to their fingers and the bulky dressings covering them. A simple tracheal occluder can be made out of a ping-pong ball and a syringe casing. The device presented in this article allows for the restoration of speech in the types of patients described above, and it promotes purposeful movement of their upper extremities.

New ideas in splinting of burns.

Splinting in burns is by no means a new subject, but this paper tries to demonstrate a new approach using new materials and sometimes humour. Conventional burn splints, dynamic and static, have been described in the past. All the following splints are made either with Mediplast, a new Israeli product, or Hexcelite.

The use of games in occupational therapy of hand burns.

The need for active range of motion in hand burns is obvious and through adapted games the patient's interest is aroused and provides an incentive for active participation in his/her therapeutic programme. All the games are for individual players, on different intellectual levels, and provide different active ranges of motion: for fingers, wrist, elbow and shoulder. Most of the games were made by a former patient, now retired, copied from games in the collection of the occupational therapist, and some of the games are of Israeli idea and manufacture. All the games can be gas autoclaved and therefore be used from patient to patient. The games also provide a much needed outlet for intellectual stimuli and distraction from the burns unit and all it signifies.

Pressure garments in the control of hypertrophic scarring and rehabilitation of the burn patient: an occupational therapy approach.

During the first 2 years of its existence, the Jobst Service of the Soroka Medical Center treated 150 patients, including 29 casualties of the Lebanon War, 1982, for postburn hypertrophic scarring. The Jobst pressure-gradient burn garments were successful in the control of hypertrophic scars, and in shortening the patient's rehabilitation time. The discussion stems from the perspective of the occupational therapist for treatment planning, paying special attention to the physical and psychosocial problems that confront the thermally injured patient, and to the need for total patient care.