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Published on: June 1, 2016
A comparison study of methods for estimation of a burn surface area: Lund and Browder, e-burn and Mersey Burns
Hsu Phie Chong1, Linda Quinn1, Amy Jeeves1
1Department of Burns Surgery, Women's and Children's Hospital (WCH), Australia.
Insights
Estimating pediatric burn surface area is challenging. Mobile applications like e-burn improve accuracy, especially for less experienced clinicians, reducing errors in burn assessment.
Area of Science:
- Medical technology
- Pediatric emergency medicine
- Burn management
Background:
- Accurate estimation of Total Burn Surface Area (TBSA) is critical for effective burn care, particularly in pediatric patients.
- Traditional methods for TBSA calculation can be challenging due to patient growth and age-related anatomical differences.
- Existing methods may lead to inaccuracies, impacting fluid resuscitation and treatment decisions.
Purpose of the Study:
- To assess the reliability of three modalities: Lund-Browder chart (LB), Mersey Burns (MB), and e-burn (EB) for calculating TBSA in pediatric burn injuries.
- To compare the usability and efficacy of these TBSA estimation tools.
- To evaluate the impact of clinical experience on the accuracy of TBSA calculations using different modalities.
Main Methods:
- Forty-five healthcare professionals (doctors, nurses, students) participated in the study.
- Participants used LB, MB, and EB to calculate TBSA on simulated pediatric burn cases (12 months and 4 years old).
- Participants were categorized into burns-naïve, burns-experienced, and burns-expert groups.
Main Results:
- The burns-naïve group showed higher TBSA estimation means and greater variance compared to experienced groups.
- A statistically significant interaction was found between clinician experience level and the use of applications in estimating TBSA, particularly for larger burns.
- While both MB and EB reduced errors, EB demonstrated more favorable results in this study.
Conclusions:
- Innovative software and mobile applications hold significant potential as adjuncts in burn care, improving health outcomes.
- Technology-aided TBSA assessment models can reduce human error, especially among less specialized clinicians.
- Further research is necessary to fully determine the clinical impact of these advanced assessment tools on overall patient outcomes.
Introduction:
One of the greatest challenges in burn care is the estimation of a total burn surface area (TBSA). It is especially challenging and needs to take into account the growing proportions and the age of a paediatric patient. The aims of this study is to: (1) assess the reliability of the three modalities (LB, MB, and EB) in calculating the extent of burn injuries and fluid resuscitation, and (2) compare the features in terms of usability and efficacy.
Methods:
Participants were recruited from Women's and Children's Hospital (WCH), South Australia's surgical and emergency department. Participants were introduced to LB, MB and EB, and then commenced calculation of TBSA on two simulated paediatric (patient A: 12 months, patient B: 4 years) burns. The participants were categorized into three groups; (1) Burns-naïve, (2) Burns-experienced, and (3) Burns-expert.
Results:
A total of 45 participants took part in this validation study: doctors (49%), nurses (33%), nursing students (11%) and medical students (7%). The burns-naïve group demonstrated higher means in both patients and has greater variance, TBSA mean 28.8%, range 14-40.5% and mean 37.4%, range 20-52.3% in patient A and B respectively. Two-way ANOVA analysis shows a statistically significant interaction between the effects of level of experience and use of applications on estimation of TBSA in larger burns.
Conclusion:
Innovative software and mobile applications demonstrate a high potential as clinical adjuncts in achieving better health outcomes in any health care system. Both Mersey Burns and e-burn reduced the risk of human error particularly from untrained or non-specialised clinicians, however, e-burn proved to be more favourable in our study. Technology-aided models are the future of burns assessment, and further studies are warranted to determine their impact on overall clinical outcome.
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