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Accurate burn size estimation is critical for patient care. Studies show significant miscalculations in total body surface area (TBSA) burns, leading to inappropriate transfers and resource misuse.

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Area of Science:

  • Emergency Medicine
  • Surgical Sciences
  • Medical Informatics

Background:

  • Accurate burn size estimation is vital for effective acute burn management.
  • Misestimation of total body surface area (TBSA) leads to increased healthcare costs and delayed care.
  • Current TBSA estimation methods often lack precision.

Purpose of the Study:

  • To systematically review the literature on the prevalence and impact of TBSA miscalculations in burn injuries.
  • To identify factors contributing to TBSA misestimation.
  • To highlight the consequences of inaccurate burn size assessment.

Main Methods:

  • A systematic literature review was conducted across major scientific databases (PubMed, Scopus, Google Scholar, OvidSP Medline, Web of Science).
  • Twenty-six relevant articles were evaluated by a panel of reviewers.
  • Data on TBSA miscalculations, influencing factors, and clinical outcomes were extracted and analyzed.

Main Results:

  • Pervasive TBSA miscalculations were identified, ranging from 5% to 339%.
  • Burns < 20% TBSA were disproportionately overestimated, leading to up to 77% of burns being inappropriately transferred.
  • Factors like improper use of estimation tools and failure to account for patient demographics contributed to errors.

Conclusions:

  • TBSA misestimation is a significant problem in acute burn care, impacting patient transfers and resource allocation.
  • Inaccurate assessments can lead to over-resuscitation of smaller burns and potentially under-resuscitation of larger ones.
  • A systematic approach, potentially using telemedicine and computer-based assessments, is needed to improve TBSA accuracy.