A measure of the extent of burn injury based on fluid resuscitation

This study was undertaken in an attempt to develop an objective method of measuring the severity of burn injury not subject to the personal bias of the observer. The classic method of assessing burn size--the estimation of the percentage body surface area burned--provides a systematic error peculiar to each observer so that it is not possible to compare results from one burn treatment centre to another. To assess the accuracy of a new objective method for measuring the extent of burn injury--the estimation of fluid retention over the first 48 h after burning--and to compare the new method with the classic method, we measured net fluid retention and the percentage body surface area burned for 52 patients who were treated at the Massachusetts General Hospital or Shriners Burns Institute, Boston Unit, between November 1968 and July 1980, and compared these measurements with clinical scores indicating the extent of burn injury. Analyses of the data showed that net fluid retention is an accurate measure of the extent of burn injury, and approximately equivalent to the percentage body surface area burned when the estimates of percentage burn are made by a small, consistent clinical team in a single burn care system.