Which intervention is most appropriate immediately after skin grafting of the dorsum of the hand?

• A. Immobilization of all hand activities
• B. Use of a safe-position splint over the dressings
• C. Resistive grasp activities to promote graft adherence
• D. Early aggressive PROM to the wrist and hand

Answer: (B)

Immediately after a skin graft on the dorsum of the hand, protecting the graft from movement and shear is the top priority to promote take. Using a safe-position splint over the dressings achieves this by immobilizing the hand in a position that minimizes tension across the graft and prevents disruption of the new vascular connections as the graft adheres to the underlying bed. This typically means the wrist is held in a neutral to slight extension and the fingers are positioned in a resting, intrinsic-plus–like posture that slackens the extensor mechanism on the dorsum, reducing graft stress. The splint also shields the graft from accidental trauma and helps control edema with elevation. In contrast, activities that involve resistance or aggressive motion would apply forces to the graft and risk tearing or shear, undermining healing.