• J. Surg. Res. · Jan 2018

    Comparative Study

    Comparison of the Lund and Browder table to computed tomography scan three-dimensional surface area measurement for a pediatric cohort.

    • R Wolfgang Rumpf, Stewart William C L WCL The Battelle Center for Mathematical Medicine at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio., Stephen K Martinez, Chandra Y Gerrard, Natalie L Adolphi, Rajan Thakkar, Alan Coleman, Adrian Rajab, William C Ray, and Renata Fabia.
    • The Battelle Center for Mathematical Medicine at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio.
    • J. Surg. Res. 2018 Jan 1; 221: 275-284.

    BackgroundTreating burns effectively requires accurately assessing the percentage of the total body surface area (%TBSA) affected by burns. Current methods for estimating %TBSA, such as Lund and Browder (L&B) tables, rely on historic body statistics. An increasingly obese population has been blamed for increasing errors in %TBSA estimates. However, this assumption has not been experimentally validated. We hypothesized that errors in %TBSA estimates using L&B were due to differences in the physical proportions of today's children compared with children in the early 1940s when the chart was developed and that these differences would appear as body mass index (BMI)-associated systematic errors in the L&B values versus actual body surface areas.Materials And MethodsWe measured the TBSA of human pediatric cadavers using computed tomography scans. Subjects ranged from 9 mo to 15 y in age. We chose outliers of the BMI distribution (from the 31st percentile at the low through the 99th percentile at the high). We examined surface area proportions corresponding to L&B regions.ResultsMeasured regional proportions based on computed tomography scans were in reasonable agreement with L&B, even with subjects in the tails of the BMI range. The largest deviation was 3.4%, significantly less than the error seen in real-world %TBSA estimates.ConclusionsWhile today's population is more obese than those studied by L&B, their body region proportions scale surprisingly well. The primary error in %TBSA estimation is not due to changing physical proportions of today's children and may instead lie in the application of the L&B table.Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

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