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Slow recruitment.
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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Early mobilization | Experimental |
| |
| Late mobilization | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Early Mobilization | Other | 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. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Wound healing | Percent graft take | Post-operative day 5 |
| Measure | Description | Time Frame |
|---|---|---|
| Wound healing | Percent graft take | Post-operative day 14 |
| Post-operative clinical outcomes | Elbow range of motion measured using a goniometer. |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Sunnybrook Health Sciences Centre | Toronto | Ontario | M4N 3M5 | Canada |
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| ID | Term |
|---|---|
| D002056 | Burns |
| ID | Term |
|---|---|
| D014947 | Wounds and Injuries |
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| ID | Term |
|---|---|
| D004434 | Early Ambulation |
| ID | Term |
|---|---|
| D012046 | Rehabilitation |
| D000359 | Aftercare |
| D003266 | Continuity of Patient Care |
| D005791 | Patient Care |
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| Late Mobilization | Other | The patient's grafted upper extremity will be immobilized using an elbow flexion blocking splint until post-operative day 5. |
|
| 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) | 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). | Acute hospital stay, up to one year |
| Discharge outcome - disposition | Discharge disposition | Acute hospital stay, up to one year |
| Discharge outcome - readiness | Timing of readiness for discharge. | 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. | Acute hospital stay, up to one year |
| D013812 |
| Therapeutics |