Footwear and orthotic prescription after burns or necrotising fasciitis affecting the lower limb: a retrospective audit.

Lauren Davies¹, Anita Plaza¹, Chloe Pearce¹, Brooke Mulliss¹, Charlotte Jackson¹, Charlotte Kiemann¹, Helen McDonald²,
¹Physiotherapy Department, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia
²Prosthetics and Orthotics Department, Royal Brisbane and Women’s Hospital, Brisbane, QLD, Australia

Abstract

Aim: To investigate footwear and orthotic prescription after burns and necrotising fasciitis involving the lower limb and determine current best practice.

Design: Retrospective review, literature review and benchmarking audit.

Method: A retrospective review was conducted of all patients admitted to the Professor Stuart Pegg Adult Burn Centre between July 2021 and June 2022 with burns or necrotising fasciitis involving the lower limb. Demographics, injury characteristics and type / frequency / cost of prescribed footwear and orthotics were collected and analysed using descriptive statistics. A literature review and benchmarking audit with other Australian and New Zealand burn centres was also conducted to ascertain best practice.

Results: 203 patients (81% males) with a mean age of 43 years and a mean burn size of 10% were included. 146 (72%) were managed with surgical intervention, with a mean of 1.6 operations for wound closure, 3 requiring amputation. 121 (60%) of injuries involved the ankles, feet and toes. Only 4% had necrotising fasciitis. 84 (41%) were prescribed footwear of which 77 were sheepskin lined boots. Four ankle foot orthoses were prescribed for foot drop due to nerve injury or excised tendons. Total cost of sheepskin footwear provided in this timeframe was $10,395. Results of the benchmarking audit will also be presented.

Conclusion: This review describes the footwear and orthotic prescription at the adult burn centre in Brisbane and aims to identify current best practice. The results are integral to developing improved guidelines for the prescription of modified footwear and orthotics after lower limb injury.

Biography

Miss Lauren Davies is a rotational Physiotherapist currently working in the Professor Stuart Pegg Adult Burn Centre at the Royal Brisbane & Women’s Hospital. Lauren has an interest in Burns, Plastics, and reconstructive surgery. She is committed to professional development and research activities that improve service delivery and patient care.