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Potential complications of autografting for burn wound coverage of the hand include edema, hematoma formation, and bleeding; all of which can lead to graft failure. Self-adherent elastic wraps are commonly used by burn rehabilitation clinicians to minimize complications by providing graft protection and decreasing edema post-operatively; however, there is a lack of evidence on its impact on graft healing. The purpose of this study was to determine if the application of self-adherent elastic wraps to the hand in the operating room after autografting improves the percentage of graft viability. Methods A retrospective chart review was performed for 37 patients with burned hands who underwent autografting from January 2017 to July 2021. Grafted hands were categorized into 2 groups: post-operative dressings with and without self-adherent elastic wraps. Post-operative day 4 pictures for both groups were collected from the medical record and a blinded digital photograph analysis of graft viability was performed by 5 expert raters including 3 Burn Surgery Fellows,1 Burn Attending Surgeon and 1 Hand Attending Surgeon. A rating system was developed based on percentage of graft take as seen in Table 1 and presence of hematomas were assessed. Results Patients who received self-adherent elastic wraps suffered burns with significantly larger TBSA (p=0.007) and were admitted for a longer duration (p=0.009) than patients who did not. Patients with elastic wrap had a higher percentage of grafts with &amp;gt;95% take (64.0% vs 41.7%, p=0.227) and a lower rate of hematoma formation (24.0% vs. 41.7%, p=0.443). Intra-class correlation coefficient across raters was 0.90 for graft take and 0.87 for determining presence of hematomas, indicating excellent interrater reliability. Conclusions Despite suffering larger burns requiring longer hospitalizations, patients who received elastic wrap had a higher rate of &amp;gt;95% graft take than those without. This study is limited by a relatively small sample size, however these findings warrant continued research in the use of self-adherent elastic wrap to maximize graft take in hand burns.

81 Post-operative Self-adherent Compression Wrapping of the Hand and Its Impact on Skin-graft Viability