Rationale: There is currently no observational study or randomized clinical trial published evaluating the impact of early versus late mobilization in the upper extremity after split thickness skin autograft. As the current post-operative care protocols vary based on physician preference, evidence is needed to optimize post-operative rehabilitation protocols guided by evidence which optimize wound healing, extremity range of motion, graft site pain, as well as minimize risks of complications and length of stay in hospital. Objective: To determine if early mobilization is non-inferior to late mobilization of the upper extremity after split thickness skin autograft with regards to wound healing measured as percent graft take on post-operative day 5 in adult burn patients.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
2
Range of motion exercises of the upper extremity will be performed under the guidance of the physical therapy team starting on post-operative day 1.
The patient's grafted upper extremity will be immobilized using an elbow flexion blocking splint until post-operative day 5.
Sunnybrook Health Sciences Centre
Toronto, Ontario, Canada
Wound healing
Percent graft take
Time frame: Post-operative day 5
Wound healing
Percent graft take
Time frame: Post-operative day 14
Post-operative clinical outcomes
Elbow range of motion measured using a goniometer.
Time frame: Post-operative day 5 and 14
Post-operative clinical outcomes
Graft site pain measured using visual analogue scale (0 - no pain to 10 - worst possible pain)
Time frame: Post-operative day 5 and 14
Post-operative complications
Local complications (seroma, hematoma, infection, graft loss) and systemic complications (infection, deep vein thrombosis, pulmonary embolism, myocardial infarction, mortality).
Time frame: Acute hospital stay, up to one year
Discharge outcome - disposition
Discharge disposition
Time frame: Acute hospital stay, up to one year
Discharge outcome - readiness
Timing of readiness for discharge.
Time frame: Acute hospital stay, up to one year
Discharge outcome - length of stay
Length of stay in hospital. From date of admission to date of discharge.
Time frame: Acute hospital stay, up to one year
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