Splinting strategies and controversies

Splinting is a common burn care intervention strategy based on logical anatomic and biomechanical principles. The persistence of scar contraction requires countermeasures, frequently splints, and most clinicians would concur that splints are valuable in opposing these contraction forces. Clinical decisions about splinting are often made on respected opinion, leading mainly to design and application options. Variables that affect splinting strategy include the risk-to-benefit ratio of the splint, the timing of the application, the choice of splint design, and duration of the splinting intervention. The most common of these variables reported in the literature is simply unique designs for splints. Although there are different splint designs for similar problems, no data exist to favor one design over another. Controversy about splinting in burn care is not based on the rationale for and success of splinting but exists because of the paucity of validation of its use.