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The full scope of hand-burn treatment can be challenging, even for a skilled surgeon. Specifically, pediatric palmar contact burns, a common injury in young children,1 are currently becoming a widely-discussed topic due to their increasing incidence. The risk is increasing, especially in early childhood when the hand is a tool for interacting with the environment. Combined with the child’s inherent curiosity, slower withdrawal reflex and thinner skin barrier, this sets the stage for the development of deep contact burns when the child is exposed to heated surfaces such as fireplaces, cookers or irons for a prolonged period of time.2,3 There are several specific histological and anatomic features that make skin grafting to the palm quite demanding. Glabrous skin a thick type of skin occurring on the palms and feet is more durable and less elastic, making it able to withstand pressure and traction. The epidermal part is coarse, stratum corneum that reaches a thickness of 400 – 600 um (while it is only 75 – 150 um on the rest of the body). It contains numerous sweat glands, tactile corpuscles, and is highly vascularized.4 On the other hand, melanocytes are sporadic and sebaceous glands and hair follicles are absent. Considering anatomic peculiarities, ligamentous apparatus needs to be mentioned. Palmar cutaneous ligaments run from the synovial tendon sheath to the skin, while dorsal cutaneous Annals of Burns and Fire Disasters Pending Publication