Table 5.

Burn Rehabilitation Guidelines

Pre-CEA (24-72 h of admission)   The patient was identified as a CEA candidate.   PT/OT evaluations completed.   OR for BWE + allograft or skin substitute.     The skin sample was harvested and sent for CEA growth.

Pre-CEA (3- to 4-week period)   Daily hydrotherapy and burn wound assessment to decrease the risk of infection.   OR for re-excision to decrease necrotic tissue as needed.   Therapy intervention is extremely important (2 sessions per day):     Elongation + positioning interventions to maintain adequate motion.     Muscular strength + endurance training.

Post-CEA (POD 0-1)   Immediate therapy intervention:     Positioning to decrease pressure on CEA.     PT/OT assistance in all patient movements to decrease shear.     Complex wound care, bilirubin light treatment.

Post-CEA (POD 2-6)   Elongation/ROM (2+ h/day):     Requires at least 2 therapists to be present.   Out-of-bed mobilization:     Initiated with MD approval.

Post-CEA (7-10+)   Resume treatment in the burn therapy clinic.     2-5 h intensive therapy session (5-7 days/week).   Discharge to the next level of care or home.     Admission to inpatient burn rehabilitation (IRF).

Abbreviations: BWE, burn wound excision; CEA, cultured epidermal autografts; OR, operating room; ROM, range of motion.