Wound Closure Index: a guide to prognosis in burned patients

Speed of closure of the burn wound has been shown to influence survival in several large series, yet is difficult to quantitate. A computerized wound mapping system is described which records and computes the extent of the burn wound and its rate of closure. The program stores, displays, and modifies a series of Lund and Browder charts for each patient. The percentage of the wound which is open is computed. Linear regression analysis is used to compute a Wound Closure Index (WCI). The hospital courses of 40 consecutive patients treated for major burns were analyzed using this system. Patients with less than 20% BSA burned, or with burns requiring less than 2 weeks' hospitalization, were excluded from the study. There were 31 survivors and nine who died. Mean WCI for survivors was 1.40, contrasted with 0.44 for nonsurvivors (p less than 0.001). To minimize the effects of age, patients over 60 years old were considered separately. Discriminant analysis applied to this subgroup confirmed that WCI was an accurate predictor of mortality. The system provides an accurate record of changes in the burn wound. The WCI gives an objective measure of wound closure which correlates with survival.