Mobilisation audit post lower limb burns

Emily Curtis¹, Brad Schmitt¹,
¹Royal Adelaide Hospital, Adelaide, South Australia, Australia

Abstract

Emerging evidence (Retrouvey et al. 2018) supports early mobilisation (prior to day three post operatively) for burns patients as preferred strategy to reduce incidence of deconditioning, reduce hospital length of stay (LOS) and provide good graft healing. The aim of this audit was to determine days to sit out of bed and first weight bearing post different lower limb burns interventions, LOS, identify any complications and audit compliance with our current mobilisation protocols.

Lower limb burns patients admitted between July 2021 to June 2022 were identified using the Bi-NBR and case notes were audited. Information collated and analysed included TBSA, location of burn, burn mechanism, burn management, time to mobilise, complications and LOS. Auditing of 146 patients occurred. Graft loss occurred in 2.8% of patients. Greater than five days to mobilise occurred in 5% of the patients.

Overall, lower limb burns managed with skin graft, temporary skin substitute or conservatively were weight bearing at a mean of 2.3, 1.7 and 0.5 days respectively. Skin grafts distal to, and including, the ankle were slowest to weight bearing at a mean of 3.1 days. For these patients if weight bearing occurred at day four or greater there was a longer mean LOS of 7.8 days, compared to mean LOS of 6.3 days when weight bearing at day three or less.

As of January 2023, lower limb skin grafts are weight bearing by at least day three post operatively as a standard protocol. A follow up audit will be conducted to check compliance and outcomes.

Reference
Retrouvey, H, Wang, A, Corkum J, Shahrokhi S 2018, ‘The Impact of Time of Mobilisation After Spilt Thickness Skin Graft on Lower Extremity Wound Healing – Systematic Review and Meta-analysis’, Journal of Burn Care & Research, vol 39, no. 6, pp. 902-910

Biography

Emily Curtis and Brad Schmitt job share as senior burns physiotherapist in the Royal Adelaide Hospital burns unit.