Early ambulation following lower limb burn and surgery is associated with improved long-term functional outcome and reduced hospital length of stay: A longitudinal cohort study.

INTRODUCTION

Ambulating early after lower limb burn surgery has been associated with a multitude of in-hospital and short-term benefits. However, long-term functional recovery following lower limb burns is poorly understood, especially if grafting surgery is required.

OBJECTIVES

This study aimed to explore the association between early ambulation following lower limb burn injury and surgery, long-term lower limb functional recovery and secondly, hospital length of stay (LOS).

METHODS

This retrospective longitudinal cohort study reported data from 1718 adult patients treated by a tertiary hospital burn center in Western Australia between February 2011 and December 2019 following a lower limb burn injury.

RESULTS

Comparable lower limb function outcomes were found at six weeks after injury regardless of burn severity or timing of ambulation. Early ambulation pathways were associated with the likelihood of achieving a better long-term functional recovery over the first year after burn. A positive association was also confirmed between early ambulation and hospital LOS. After adjustment, patients who ambulated early after burn and surgery had a LOS of 1.76 days less than patients who ambulated early after burn but late after surgery (IRR 1.22, 95 % CI:1.13-1.3, p < 0.001).

CONCLUSION

Early ambulation before the third day after lower limb burn injury and surgery was associated with improved long-term functional outcome trajectory to one year and reduced hospital LOS by of 1.76 days when patients ambulated early after surgery. Future investigations with larger, targeted samples of complex patients are warranted to explore the influence of early ambulation on the outcomes of multi-morbidity subgroups.