Justin H Wong,1 Dylan Singh,2 Alan A Parsa,1 Fereydoun D Parsa1
1 John A. Burns School of Medicine, University of Hawaiʻi, Honolulu, HI
2 Stanford University School of Medicine, Palo Alto, CA
3 The Queen’s Health System, Honolulu, HI
Burns involving the hands require urgent and precise management due to their critical functional role. While superficial burns often heal with conservative care, deep partial-thickness burns pose a higher risk of complications, including infection, scarring, and functional loss. This study evaluates a technique that uses intradermal fluorescein dye to guide tangential excision of nonviable tissue. Within 24–48 hours of injury, 5 mg of fluorescein dye was injected intradermally; under Wood’s light, areas lacking fluorescence were excised using a dermatome or free-hand knife until fluorescence reappeared. Split-thickness skin grafts (0.015–0.018 inches) were then applied. Among 20 patients, 16 (80%) achieved complete graft take, while 4 (20%) had minor partial graft loss (5–10%). No infections, hematomas, seromas, or contractures were reported. All patients achieved satisfactory functional and cosmetic outcomes and returned to work. Fluorescein-guided excision may enhance precision and improve graft success. Further comparison with standard assessment techniques is warranted.
