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Most Surgeons do not Immobilize Extremities After Split-Thickness Grafting for Burn Wounds

A study recently published in the Annals of Plastic Surgery Journal revealed that a majority of active burn surgeons do not practice immobilization of extremities after placement of split-thickness graft, unless there is joint involvement.

This was a cross-sectional study involving active burn surgeons in a questionnaire-based online survey. The questionnaire included 22 questions related to mobilization and 7 demographic-related questions.

A total of 337 members of the American Burn Association agreed to participate in the study. Out of these 337 members, 71 participants responded to demographic-related questions and 59 of them responded to questions regarding mobilization. Most of the participants were practicing in a center certified by the American Burn Association and they had 10 years of experience in burn care.

The study revealed that 68% of the participants followed standard protocols of postoperative autograft mobilization. When upper extremities were involved without joints, a majority (66%) of participants did not follow immobilization. Although with wrist and elbow joint involvement, 73% often immobilized these parts. The same pattern was observed when a lower extremity was involved, with 63% of them who did not mobilize without joint involvement. When knees and ankles were involved, 70% of them immobilized. The most common duration of immobilization was typically observed as 3 or 5 days.

The findings of the study suggest that most of the practicing burn surgeons do not follow immobilization of extremities after split-thickness graft placement. Most of them immobilize upper or lower extremities for 3 or 5 days, only when joints are involved. Though the practices of the burn surgeons varied, the current lower extremity immobilization practices are usually based on the guidelines proposed by Nedelec et al in 2012.

Source: Retrouvey H, Adibfar A, Shahrokhi S. Extremity Mobilization After Split-Thickness Skin Graft Application: A survey of current burn surgeon practices. Ann Plast Surg. (2020); 84(1):30-34.

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