Miss Marnie Macfie¹, Miss Catherine  Sharpe¹, Ms Anita Plaza¹, Ms Julie Adsett¹

¹Royal Brisbane And Women’s Hospital, Brisbane, Australia

Abstract:

After split thickness skin grafts (STSG), patients may be managed as either inpatients or outpatients in the immediate post-operative phase.  Little is known about movement outcomes following management in each of these settings. This study compared mobility and range of motion (ROM) outcomes in patients managed post-operatively in inpatient and outpatient settings at the Royal Brisbane and Women’s Hospital (RBWH).

Methods: A retrospective chart review was conducted of all patients requiring a single procedure STSG to the upper limb (UL) and/or lower limb (LL) between July 2017 and December 2018.  Patients were excluded if they required ICU admission or did not survive to hospital discharge.  Patient characteristics, ROM/mobility commencement times, complication rates, time to achieve full ROM/baseline mobility and costings were compared between inpatients and outpatients.

Results: 304 patients (232 inpatients, 72 outpatients) with a mean TBSA of 13.6% were included.  Compared to inpatients, outpatients were younger (mean age 32 vs 42 years, p<0.001), more likely to be non-smokers (p=0.021) and less likely to have diabetes (1% vs 9%, p=0.013).  Outpatients with LL STSG commenced full weight-bearing mobility earlier (p=0.001) but had significantly greater bleeding complications (p=0.02). Inpatients commenced ROM (p=0.002 UL, p<0.001 LL) and attained full ROM (p=0.045 UL, p=0.004 LL) earlier but incurred significantly greater total healthcare costs (p<0.001). There was no significant difference between groups for mean time to regain baseline mobility.

Conclusion: In this population, ROM outcomes were achieved earlier with inpatient management, however there was no difference between groups for achievement of baseline mobility.

Biography:

Marnie is a physiotherapist at the Royal Brisbane and Women’s Hospital who has worked in both inpatient and outpatient burn management at the Professor Stuart Pegg Adult Burns Centre.