How is burn size estimated in the initial evaluation of the burn patient?

Updated: Jan 10, 2018
  • Author: Robert L Sheridan, MD; Chief Editor: John Geibel, MD, DSc, MSc, AGAF  more...
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An accurate estimate of burn size is important for treatment and transfer decisions. Burn size or extent can be estimated in a number of ways. Perhaps most accurate is the age-specific chart based on the Lund-Browder diagram that compensates for the changes in body proportions with growth (see the image below). A burn is drawn on a cartoon figure, and an associated age-specific table is used to calculate the body surface area involved.

Initial evaluation and management of the burn pati Initial evaluation and management of the burn patient. Burn size is best estimated using a chart that corrects for changes in body proportion with aging.

An alternative in adults is the "rule of nines." This is less accurate in children because their body proportions are different from those of adults. [35] For areas of irregular or nonconfluent burns, the palmar surface of the patient's hand can be used. [36] For a wide age range, the area of the palm without the fingers represents 0.5% of the body surface.

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