Cutaneous burns

Wallace's 'rule of nines' of body surface area burn coverage[36]Hettiaratchy S, Papini R. Initial management of a major burn: II - assessment and resuscitation. BMJ. 2004 Jul 10;329(7457):101-3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC449823/?tool=pubmed http://www.ncbi.nlm.nih.gov/pubmed/15242917?tool=bestpractice.com

Burn extent is estimated as a percentage of total body surface area (TBSA):

• Head and neck represent 9% (18% in infants)

• Each lower extremity is 18% (15% in infants)

• Each upper extremity is 9% (10% in infants)

• Anterior and posterior torso are 18% each (16% in infants)

• For scattered or irregular burns the palmar surface of the patient's hand represents approximately 1%.[Figure caption and citation for the preceding image starts]: Rule of ninesFrom Dr Sheridan's personal collection [Citation ends].

Lund and Browder classification[36]Hettiaratchy S, Papini R. Initial management of a major burn: II - assessment and resuscitation. BMJ. 2004 Jul 10;329(7457):101-3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC449823/?tool=pubmed http://www.ncbi.nlm.nih.gov/pubmed/15242917?tool=bestpractice.com

Burn extent is most accurately estimated using a Lund and Browder diagram that compensates for changes in body proportions with age. This approach evaluates the surface area of the burn on the basis that a patient's palm is approximately 1% TBSA.[Figure caption and citation for the preceding image starts]: Lund-Browder diagramFrom Dr Sheridan's personal collection [Citation ends].