Update on the Practice of Splinting During Acute Burn Admission From the ACT Study

Area of Science:

• Rehabilitation Medicine
• Burn Care
• Orthopedics

Background:

• Burn scar contracture (BSC) limits range of motion and function.
• Static splinting is a common but poorly researched preventative practice for BSC.
• Previous surveys indicated divergent splinting practices among therapists.

Purpose of the Study:

• To assess current practices of static splinting for burn injuries during acute hospitalization.
• To identify factors associated with the use of splinting in burn patients.

Main Methods:

• Review of a subset of patients from the Burn Patient Acuity Demographics, Scar Contractures and Rehabilitation Treatment Related to Patient Outcome Study (ACT) database (2010-2013).
• Analysis of patient demographics, burn characteristics, rehabilitation treatments, and hospital course.
• Univariate and multivariate analyses were performed to identify factors related to splinting.

Main Results:

• Thirty percent of patients (75) received splinting.
• Splinting was associated with larger burns, increased injury severity, and need for skin grafting (OR=6.0).
• Splinting was initiated around 35% of hospital length of stay, worn for 50% of LOS, and wrist was most frequently splinted.

Conclusions:

• Current splinting practices for acute burn injuries remain variable in initiation, duration, and wear time.
• Splinting is independently associated with skin grafting requirements, particularly within the affected cutaneous functional unit.
• Further research is warranted to evaluate the efficacy and optimize application of splinting for burn scar contracture prevention.