BACKGROUND / PURPOSE: The standard protocol for ambulating patients following split-thickness skin grafts to the lower extremity is an initial several days of immobilization. Research over the past decades supports a trend towards earlier ambulation, however burn clinics nation wide have been hesitant to implement such protocols.1 The purpose of this literature review was to answer to the following PICO question: In adults with lower extremity split thickness skin grafts secondary to full-thickness burns, is early ambulation better than late ambulation in regards to preserving functional mobility while ensuring graft healing? CASE DESCRIPTION: The patient was a 22-year-old male with no significant past medical history, admitted for partial and full thickness flame burns to the posterior aspect of the left lower extremity covering approximately 4% of his total body surface area. METHODS: An electronic search of the literature was performed with a critical appraisal of eight articles. Chosen studies compared early ambulation, defined as ≤ 3 days of bed rest, to late ambulation, defined as \u2265 4 days of bed rest, on graft healing.2 OUTCOMES: There was a consensus in the literature supporting immediate ambulation of patients with isolated lower extremity burns. No studies of any patient population showed that early ambulation compromises graft take. CONCLUSION: Immediate ambulation is a safe intervention for patients who were previously ambulatory, are medically and psychologically stable, with wounds <300cm2 that are not on the plantar surface of the foot. Ambulation is safe to begin once the patient recovers from anesthetic (4 to 48 hours post-op) with compression wrapping and splinting of any joints the graft crosses.
Submitted by Aubrey Rimer (email@example.com) on 2015-06-22T22:02:49Z No. of bitstreams: 2 Rimer_Capstone.pdf: 1303816 bytes, checksum: 217dd575a9306ed76affac230251ace4 (MD5) Rimer_ Poster_Ambulation Following Lower Extremity Skin Grafts.pdf: 1506170 bytes, checksum: e718861122223907dd46945829619e9c (MD5), Made available in DSpace on 2015-06-22T22:02:49Z (GMT). No. of bitstreams: 2 Rimer_Capstone.pdf: 1303816 bytes, checksum: 217dd575a9306ed76affac230251ace4 (MD5) Rimer_ Poster_Ambulation Following Lower Extremity Skin Grafts.pdf: 1506170 bytes, checksum: e718861122223907dd46945829619e9c (MD5) Previous issue date: 2015-06
Rimer, Aubrey. "Ambulation Following Lower Extremity Skin Grafts." (2015). http://digitalrepository.unm.edu/dpt/123