Thermal injuries of the hand are common in the surgeon s working routine. The correct assessment of the burned surface area and burn depth is important as it is crucial for initiating further treatment. Especially, fullthickness burns are feared due to the resulting scars which are stigmatizing and impeding. The goal is to prevent these scars effectively. In primary care, dressings with polyhexanid gel and petroleum gauze are the gold standard. New techniques such as enzymatic debridement with Bromelain and hydrosurgery are available to use for eschar removal. These methods work more selectively and are therefore helpful in the debridement of the hand due to the fine structures deserving protection. In terms of plastic reconstruction, Suprathel is an easyto-use epidermal replacement (polylactic acid) for superficial burn injuries. It reduces the frequency of dressing changes and the associated pain. Furthermore, several approved grafts for dermal replacement are available. If there is still the need for a split skin graft, it should be used unmeshed. It might become necessary, in case of profound trauma, to perform a local or even a free flap. These surgical skills are the techniques of the plastic surgeon to prevent the loss of an extremity, even in these advanced cases.