Early ambulation for patient underwent skin grafting

[micola75]

Hey dear fellow nurses..

I need some advices.I have heard about early ambulation for patients underwent skin grafting over the legs. How many post op day (POD) do you consider safe to start early ambulation for this group of patients.

In my unit, we practice rest in bed for 5 days after surgery. My surgeon usually will immobilised the legs with backslab followed by wound inspection on 5th POD.We will check skin take then the surgeon will decide for ambulation or hold on. I am thinking that it's neccessary to immobilise the leg for 5 days. Can we shorten the length of stay:uhoh3:? Sometimes, even the grafted area is about 1% over the calf, we still follow the protocol:o.

Can share with me how your unit practice? Do you start ambulate patient on 1st POD? Is there any researchs or EBN studies shows to support early ambulation? Or we have to stick to the conventional way to immobilise our poor patient for 5 days?

Your input will be greatly appreciate .. Thank You

[anvano412]

Hey...

I'm responding the question about ambulation. First, I'm just completing my 1st year as a burn nurse straight out of nursing school. I work on a certified burn / trauma center (but technicalities make us not a "real" trauma center)

Anyway, we do 1st drsg changes 3 days after grafting. If the area is like B LE in full coban drsg than they basically aren't walking. But if its 1 leg and we can help them ambulate to say the bathroom we do....they aren't on the total bedrest thing. But, they will be non-weight bearing on the extremity until 1st change so the graft can have time to take. But, we will put them in the shower chair if the affected leg can hang out....of course all w/ assistance. But 5 Days!!!! My goodness....I'm new at this, but I've heard if a graft will take it will take in 24-48 hrs. Not positive of that though.

Hope that helps a little. I'd say if it was a dime size thing and only one leg, I mean use crutches? We certainly believe in rehab asap...its better for the patient.

FYI I finished a 1st change and was like c'mon now walk back to your room. We encourage rehab and utilaztion of grafted area as tolerated as encouraged, asap!

[shandsburnRN-CRNA]

In my unit new grafts stay wrapped and immobilized until POD 3 and then full OT/PT is restarted unless something out of the ordinary is seen when dressings are first taken down (i.e. graft not taking).