Lund and Browder chart—This chart, if used correctly, is the most accurate method. It compensates for the variation in body shape with age and therefore can. Assessment of burn size: Lund and Browder chart. % total body surface area burn. Be clear and accurate, and do not include erythema. %. REGION. P. A. R. Download scientific diagram | Lund and Browder chart (with age appropriate measurements of BSA) from publication: Special considerations in paediatric burn.
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Proper care of patients with burns requires an accurate assessment of the extent of the burnt area. The common methods used to measure this are the Lund and Browder chart LB ,[ 1 ] the rule of nines[ 2 ] and the patient’s palm size method for smaller burns.
Burn wound assessment has to be done multiple times and by people with varying degrees of training and experience. The tool used for such an assessment must be as robust, precise and reliable as possible and should have the least possible scope for errors.
Lund and Browder chart
The conventional adult LB chart has anterior and posterior body schematics divided into regions which represent percentages of total body surface area. These regional percentages are often in fractions.
The actual burnt area is usually irregular and covers only a part of the region on the chart. This has now to be accurately depicted onto the paper chart and calculations have to be done.
First, the burnt fraction of the region has to be estimated and then the various fractions of different regions have to be added up.
This estimation and calculations in fractions is difficult. Each time the observer makes an estimate and a calculation, there is a potential for an error. There can be significant errors and differences between different assessors,[ 6 ] and this can have a profound effect on treatment. At our hospital, we have modified the adult LB chart in the following way [ Figure 1 ]. The assessor has to shade in or outline the burnt area on both anterior and posterior diagrams, then count the number of shaded or outlined quadrilaterals and divide by four to arrive at the total percentage of burnt body surface area.
This counting of the squares and division by four is easily done and requires no dealing in fractions. Thus, the resolution for this modified chart is 0. Calculation can usually be done mentally and the result obtained can be easily counterchecked. Results are also consistent when repeated by different assessors.
All that needs to be done is to count the number of shaded quadrilaterals and divide by four. National Center for Biotechnology InformationU. Indian J Plast Surg. Author information Copyright and License information Disclaimer.
Sir, Proper care of patients with burns requires an accurate assessment of the extent of the lund-brpwder area. Open in a separate window. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.
The estimation of areas of burns. Sabiston DC Jr, editor. W B Saunders Company; The natural history of the growth of the hand: Hand area as a percentage of body surface area.
A modified Lund and Browder chart
Chzrt S, Papini R. Initial management of a major burn: II — Assessment and resuscitation. Seyyed MM, Amir M. A comparison of burn size estimation methods’ accuracy applied by medical students. Future Med Educ J. Accuracy of burn size estimation in patients transferred to adult Burn Units in Sydney, Australia: An audit of patients. Articles from Indian Journal of Plastic Surgery: Support Center Support Center.