Early Post-Operative Mobilization After Treatment of Burn Wounds with Autologous Skin Cell Suspension is Safe

Standardized criteria for mobilization of the post-operative burn patient do not currently exist. Even the term "early mobilization" is not well defined. The use of autologous skin cell suspension (ASCS) with or without split-thickness skin grafts (STSG) has improved patient outcomes. The purpose of this study is to evaluate the safety of early post-operative mobilization, defined as mobilization with the rehabilitation team within 48 hour of surgical treatment, in patients who were treated with ASCS and a polylactic acid dressing. This is a single-center, retrospective review over a 10-month period of patients who presented with deep partial thickness and full-thickness burns. All burn wounds included in the study underwent surgical treatment of their burns with ASCS or ASCS+STSG. After surgical treatment, any patients/areas with post-operative restrictions were noted. All patients without restrictions were allowed active and/or passive range of motion (AROM or PROM) of the treated area and out-of-bed (OOB) mobilization starting on POD0. In total, 29 patients were treated with 77 separate areas undergoing surgical treatment with ASCS or ASCS + STSG; 79% of these areas involved joints. All patients underwent either AROM or PROM with the burn therapy team by POD2. Of the wounds treated with ASCS alone, 5% required patch grafting, and no graft loss was noted in those treated with STSG+ASCS. This study serves as a proof of concept that early post-operative mobilization in burn patients undergoing grafting and ASCS is safe and is not associated with graft loss, including areas involving joints.