Utility of palm and hand surface area in approximating burn extent in Burundian adults and children |
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| Institution: | 1. Department of Emergency Medicine, Kibuye Hope Hospital, BP 73 Gitega, Burundi;2. Department of Emergency Medicine, Los Angeles County + University of Southern California Medical Center, 1200 State St, Rm 1011, Los Angeles, CA 90033, United States;3. Clinique Medicale Tabarane, Nyabikere, Karusi, Burundi;1. College of Medicine and Public Health, Flinders University, GPO Box 2100, SA, 5001, Australia;2. The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, NSW, 2050, Australia;1. College of Medicine and Public Health, Flinders University, GPO Box 2100, SA, 5001, Australia;2. The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, NSW, 2050, Australia;1. The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, NSW, 2050, Australia;2. Graduate School of Health, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia;1. The George Institute for Global Health Australia, UNSW, PO Box M201, Missenden Rd, NSW, 2050, Australia;2. School of Population Health, Faculty of Medicine, UNSW, Sydney, 2052, Australia;1. State Adult Burn Unit, Fiona Stanley Hospital, 11 Warren Drive, Murdoch, Western Australia, 6150, Australia;2. Burn Injury Research Unit, University of Western Australia, Perth, Western Australia, 6009, Australia;1. School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia;2. Emergency and Trauma Centre, Alfred Hospital, 55 Commercial Road, Melbourne, Victoria, 3004, Australia;1. School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Victoria, 3004, Australia;2. Health Data Research UK, Swansea UniversityMedical School, Swansea University, Singleton Park, Swansea, Wales, United Kingdom;1. Plastic Surgery Department, Royal Manchester Children’s Hospital, Oxford Road, Manchester M13 9WL, United Kingdom;2. Manchester University NHS Foundation Trust, United Kingdom;1. Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA;2. Spaulding Research Institute, Boston, MA, USA;3. Boston University School of Public Health, Boston, MA, USA;4. Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA;5. Shriners Hospitals for Children – Boston®, Boston, MA, USA;6. Phoenix Society for Burn Survivors, Grand Rapids, MI, USA |
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| Abstract: | The use of palm and hand surface areas to approximate the extent of burns is as widespread as it is facile. However, direct comparison of measured palm and hand surface areas to total body surface areas (TBSA) have demonstrated variable accuracy in different patient populations. We measured the palm and hand surface areas of 353 Burundian adults and children, including 23 underweight children and compared those values with 0.5% and 1%, respectively, of the calculated TBSA via Mosteller, Dubois, and Haycock formulae. We used Student’s t-test to analyze for significant departure from predicted values. For 100 Burundian adults with a median BMI of 21.7 the palm and hand surface areas represented 0.40% and 0.77% TBSA, respectively. For 253 Burundian children, the mean palm and hand surface are represented 0.44% and 0.86% TBSA, respectively. Subgroup analysis of underweight children (BMI < 18.5 or Z-score ≤?2 weight for height) revealed values of 0.45% and 0.88% for palm and hand areas. Our data indicate that using values of 0.5% TBSA for the palm and/or 1% TBSA for the hand overestimates the actual burn extent and would be improved with a correction factor for Burundian patients. |
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| Keywords: | Surface area Fluid rehydration African Underweight |
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