Abstract Deep burns of the hand are a common serious surgical problem with major occupational and economic implications. Control of haemorrhage during excision and grafting is difficult and postoperative haematoma may reduce graft take. Following excision, important deep structures such as extensor tendons or joints may be exposed. Such tissues do not take free skin grafts satisfactorily. We have found calcium alginate dressings can be of immense help in minimizing these technical problems. We describe our experience in one patient; three other patients have been treated with equal success.