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Related Experiment Videos

How big is a hand?

N D Rossiter1, P Chapman, I A Haywood

  • 1Burns and Plastics Unit, Queen Elizabeth Military Hospital, Woolwich, London, UK.

Burns : Journal of the International Society for Burn Injuries
|May 1, 1996
PubMed
Summary
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Estimating burn size using a patient's hand can overestimate the percentage of body surface area (BSA) affected. This study found the palm alone is 0.5% BSA (males) and 0.4% BSA (females), challenging standard burn management teaching.

Area of Science:

  • Burn management
  • Medical measurement techniques
  • Anatomical assessment

Background:

  • Estimating burn size is critical for patient management.
  • The hand is a commonly used tool for estimating body surface area (BSA) burns.
  • Current methods for using the hand to estimate BSA lack precise definition and may lead to inaccuracies.

Purpose of the Study:

  • To accurately measure the surface area of specific hand components used in burn estimation.
  • To compare these measurements against established burn management teaching.
  • To identify potential sex differences in hand surface area relevant to burn assessment.

Main Methods:

  • Direct measurement of hand surface areas (palm alone, palm with digits).
  • Comparison of measured areas with standard teaching protocols (e.g., Advanced Trauma Life Support, UK teaching, Lund and Browder chart).

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  • Analysis of measurements for potential sex-based variations.

    • Main Results:

    • The area of the palm alone measures 0.5% BSA in males and 0.4% BSA in females.
    • The area of the palm plus the palmar surface of the five digits measures 0.8% BSA in males and 0.7% BSA in females.
    • These findings challenge the accuracy of standard teaching methods for hand-based BSA estimation.

    Conclusions:

    • Using the entire hand to estimate burn size can lead to overestimation of the percentage of body surface area (BSA) affected.
    • There is a demonstrable sex difference in the BSA represented by hand components.
    • Standard burn management teaching regarding hand size for BSA estimation requires re-evaluation.