Burn Center Mobility Protocol

Original Date: 06/01/2022
Purpose: To standardize mobility procedures in the Burn Center to ensure patients get out of bed in a manner that protects autografts and prevents deconditioning.

Goal: Every *eligible patient will mobilize out of bed to a chair and/or walk every day of their hospitalization.

Burn Wound Considerations:

Non-operative burn wounds:

  • ROM: no restrictions
  • Activity: no immobilization required, EOB/OOB once wounds assessed

Excised wounds with allograft:

  • ROM: no restrictions
  • Activity: no immobilization required, EOB/OOB as soon as POD 1

Excised wound with autologous epidermal autograft only:

  • ROM: no restrictions
  • Activity: no immobilization required, EOB/OOB as soon as POD 1

Excised wound with split thickness, meshed autograft (including those with meshed autograft and autologous epidermal autograft):

  • ROM: begin gentle ROM on POD 2 after dressings are first changed
  • Activity: no OOB activity restrictions unless documented by surgeon in operative note
    • Lower extremity grafts to be secured with figure of 8 ACE wrap before getting EOB/OOB (can be doubled for patient comfort).
    • ACE wraps may be removed once patient returns to supine.
    • Splints should stay applied until ROM begins and then used per OT/PT instructions

Excised wounds with split thickness, meshed autograft and autologous epidermal autograft:

  • Same as split thickness, meshed autografts

Excised wound with dermal substitute (e.g. Integra):

  • Same as split thickness, meshed autografts

Regional Anesthetic Considerations

Regional blocks which do not affect motor function:

  • Activity: no activity restrictions unless documented by surgeon in operative note

Regional blocks which affect motor function:

  • Out of bed with assistance to chair until motor function returns

*Exclusions/precautions criteria:

  • Autografts on the plantar aspect of the foot
  • Current mental state
  • Ventilated patients