title: Two simple leg net devices designed to protect lower-extremity skin grafts and donor sites and prevent decubitus ulcer.
abstract: Burn therapists routinely are tasked to position the lower extremities of burn patients for pressure ulcer prevention, skin graft protection, donor site ventilation, and edema reduction. We developed two durable and low-maintenance devices that allow effective positioning of the lower extremities. The high-profile and low-profile leg net devices were simple to fabricate and maintain. The frame was assembled using a three-quarter-inch diameter copper pipe and copper fittings (45 degrees, 90 degrees, and tees). A double layer of elasticized tubular netting was pulled over the frame and doubled back for leg support to complete the devices. The devices can be placed on any bed surface. The netting can be exchanged when soiled and the frame can be disinfected between patients using standard techniques. Both devices were used on approximately 250 patients for a total of 1200 treatment days. No incidence of pressure ulcer was observed, and graft take was not adversely affected. The devices have not required repairs or replacement. Medical providers reported they are easy to apply and effectively maintain proper positioning throughout application. Neither device interfered with the application of other positioning devices. Both devices were found to be an effective method of positioning lower extremities to prevent pressure ulcer, minimize graft loss and donor site morbidity, and reduce edema. The devices allowed for proper wound ventilation and protected grafted lower extremities on any bed surface. The devices are simple to fabricate and maintain. Both devices can be effectively used simultaneously with other positioning devices.
authors.affiliation: United States Army Institute of Surgical Research, Army Burn Center, Fort Sam Houston, Texas 78234, USA.
authors.forename: Travis L
authors.initials: TL
authors.lastname: Hedman
authors.forename: Ted T
authors.initials: TT
authors.lastname: Chapman
authors.forename: William S
authors.initials: WS
authors.lastname: Dewey
authors.forename: Charles D
authors.initials: CD
authors.lastname: Quick
authors.forename: Steven E
authors.initials: SE
authors.lastname: Wolf
authors.forename: John B
authors.initials: JB
authors.lastname: Holcomb
mesh_terms: D002056:Burns / Q000150:complications / Q000628:therapy*; D004389:Durable Medical Equipment; D004487:Edema / Q000517:prevention & control; D004867:Equipment Design; D006085:Graft Survival; D006801:Humans; D035002:Lower Extremity; D011187:Posture; D003668:Pressure Ulcer / Q000209:etiology / Q000517:prevention & control*; D016038:Skin Transplantation; D014691:Ventilation