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Published on: February 2, 2017
Review of methods to determine hand surface area of children less than six years old: a case study
Hanna Perone1, Kyra Rattler2, Alesia C Ferguson3
1Department of Civil, Architectural, and Environmental Engineering, University of Miami, Coral Gables, FL, USA.
Insights
Accurate hand surface area (HSA) measurement is crucial for children
Area of Science:
- Pediatric Medicine
- Biometrics
- Environmental Health
Background:
- Accurate hand surface area (HSA) determination is vital for risk assessments and clinical decisions in children.
- Existing HSA measurement methods lack consistency, particularly for pediatric populations.
- Children's vulnerability to environmental contaminants and medication side effects necessitates reliable HSA data.
Purpose of the Study:
- To evaluate the accuracy of existing methods for determining pediatric hand surface area (HSA).
- To compare various HSA measurement techniques against direct hand tracings in children.
- To develop age-group-specific ratios for estimating HSA in children.
Main Methods:
- 122 children (aged 0-6 years) underwent hand tracings, digitized using ImageJ for HSA calculation.
- Six established HSA determination methods were applied, using child's height, weight, and hand dimensions.
- Statistical analysis compared results from the six methods against the ImageJ-derived HSA.
Main Results:
- Five of the six tested methods showed statistically significant differences compared to direct hand tracings (p < 0.001).
- One method, providing a uniform hand to total body surface area (TBSA) ratio, did not differ significantly.
- Novel age-group-specific HSA to TBSA ratios were proposed: 0.91% (0-2 yrs), 0.90% (3-4 yrs), and 0.87% (5-6 yrs).
Conclusions:
- Most existing HSA measurement methods are unreliable for children.
- A uniform hand to total body surface area ratio is insufficient for pediatric populations.
- Proposed age-group-specific HSA to TBSA ratios offer improved accuracy for pediatric risk assessment and clinical applications.
Abstract:
Various methods exist to determine the surface area of hands. The consistency of these methods is essential given that risk assessments utilize hand surface area (HSA) to quantify exposure to environmental contaminants. HSA is also utilized in the clinical setting to estimate size of burns, and to determine specific treatments and medication dosages. A reliable method of surface area measurement is important to guide these decisions, especially in children who are vulnerable to environmental contaminants and medication side effects. Despite this, fewer HSA-determining studies have been performed for children compared to adults. In this study, 122 children completed hand tracings, and the tracings were digitized using an ImageJ program to determine HSA. Six previously published methods of determining HSA were utilized based on the child's height, weight, and length and width of hand. Children were analyzed by age group including 0-2, 3-4, and 5-6 years. The HSA measurements determined by five of the six methods were statistically different from HSA determined using direct hand tracings/Image J methodology (p < 0.001). The single remaining study that did not differ significantly from the hand tracing method provided a uniform hand to total body surface area (TBSA) ratio for children of all ages. Based on these results, we propose a novel age-group-specific ratio utilizing the HSA results from hand tracings and TBSA calculations. The percentages of TBSA that reflect HSA for children aged 0-2, 3-4 and 5-6 years were 0.91%, 0.90% and 0.87%, respectively. These percentages should be considered for use in risk assessments and the clinical setting to guide treatment and prognosis.
