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Updated: Jun 20, 2026

Early Weight-Bearing Rehabilitation Protocol After Anterior Cruciate Ligament Reconstruction
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Therapy Driven Protocol: Early Ambulation for Lower Extremity Grafts.

Audrey M O'Neil1, Cassandra Rush1, Laura Griffard1

  • 1Richard M Fairbanks Burn Center, Indianapolis, IN, USA.

Journal of Burn Care & Research : Official Publication of the American Burn Association
|June 19, 2026
PubMed
Summary
This summary is machine-generated.

Early ambulation for burn survivors, starting POD 1, is safe and effective. This practice expedites functional recovery without increasing graft loss risk, even with lower extremity grafts crossing joints.

Keywords:
BurnEarly AmbulationPost-op ManagementRehabilitation

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Area of Science:

  • Rehabilitation Medicine
  • Burn Surgery
  • Trauma Care

Background:

  • Early post-operative ambulation (POD 1) benefits burn survivors by improving functional independence and reducing hospital stays.
  • Significant practice variability exists among burn centers regarding the timing of ambulation post-surgery.

Purpose of the Study:

  • To evaluate the safety and efficacy of early ambulation (POD 1-3) in burn survivors undergoing lower extremity skin grafting.
  • To identify factors associated with graft loss in this patient population.

Main Methods:

  • Retrospective review of 149 adult burn patients with lower extremity split-thickness skin grafts (STSG) or Autologous Skin Cell Suspension (ASCS).
  • Analysis of initial ambulation timing (POD 1-3), gait distance, and graft loss.
  • Comparison of patient characteristics between those with and without graft loss.

Main Results:

  • Initial ambulation occurred between POD 1-3 (average 1.05), with an average gait distance of 125.4 ft.
  • Twelve patients experienced minor graft loss, which healed conservatively.
  • No significant association between early ambulation and graft loss was found. Graft loss was associated with stroke, renal disorder, and prior amputation.

Conclusions:

  • Early ambulation (POD 1) can be safely implemented in burn survivors with lower extremity grafts without increasing graft loss.
  • Standardized mobility protocols, including compression and clinical assessment, are recommended to reduce practice variability and enhance functional recovery.