From 1984 through 1989, 24 patients with 30 acute palmar burns (six were bilateral) that required skin grafting were evaluated to compare the efficacy of split-thickness versus full-thickness autografting. Sixteen of the palms had split-thickness skin grafts and 14 had full-thickness skin grafts. Normal range of motion was found in 8 of 14 palms that were treated with full-thickness skin grafts and in 4 of 16 for those that were treated with split-thickness skin grafts. Significantly fewer reconstructive surgical procedures were required in the palm burns that were treated with full-thickness skin grafts (full-thickness = 3 of 14 and split-thickness = 10 of 16). The results demonstrate improved function and decreased need for reconstructive procedures when full-thickness skin grafts are used for the treatment of deep palm burns in young pediatric patients.