Pretibial injuries in the elderly: a prospective trial of early mobilisation versus bed rest following surgical treatment.

ABSTRACT

Pretibial lacerations are a common form of injury of the elderly population. With respect to graft healing, controversy exists regarding rehabilitation by early ambulation, following debridement and split skin grafting. In a prospective, randomised trial comparing early mobilisation (n = 21) with the traditional method of a period of in-patient bed rest after surgical treatment (n = 40), no statistically significant difference has been found in the percentage area of skin graft take at either 1 or 3 weeks postoperatively. The method of anaesthesia (local or general) has no significant effect on the outcome of healing. Prolonged bed rest has a detrimental effect on return to independent mobility in one third of cases. Complications related to the wound site are similar in both groups. Hospital stay averaged 12 days in those confined to bed, compared to an average of 2 days in those who were allowed to walk immediately.