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Original Article
Trauma
Lund and Browder chart—modified versus original: a comparative study
Arun Murari, Kaushal Neelam Singh
Acute Crit Care. 2019;34(4):276-281.   Published online November 29, 2019
DOI: https://doi.org/10.4266/acc.2019.00647
  • 17,106 View
  • 506 Download
  • 16 Citations
AbstractAbstract PDF
Background
The Lund and Browder (LB) chart is currently the most accurate and widely used chart to calculate total body surface area affected by a burn injury. However, it is not easy to use charts to calculate burn percentages because of the difficulty in performing mathematical calculations with the percentages attributed to various body regions that are only partially burned. It is also cumbersome to have to perform mental calculations, especially in emergency situations.
Methods
We compared results from the LB chart with a modified Lund and Browder (MLB) chart using 10 assessors on five different burn wounds each drawn on both charts.
Results
Variability of results was significantly reduced using the MLB chart compared to the LB chart.
Conclusions
Assessments performed using the MLB chart are less variable than those using the LB chart. Using this chart will help burn care providers rapidly, accurately, and reliably estimate burn extent.

Citations

Citations to this article as recorded by  
  • EasyTBSA as a method for calculating total body surface area burned: a validation study
    Cindy D Colson, Emily C Alberto, Zachary P Milestone, Nikita Batra, Tyler Salvador, Hadi Fooladi, Kevin Cleary, Rima Izem, Randall S Burd
    Emergency Medicine Journal.2023; 40(4): 279.     CrossRef
  • Temporal trends in burn size estimation and the impact of the NSW Trauma App on estimation accuracy
    Thanya Sritharan, Morgan Haines, Anne Darton, Aruna Wijewardana, Diane Elfleet, Kate Welsh, Meredeth Cassidy, Bish Soliman, Shane O’Neill, Jeon Cha, John Vandervord, Varun Harish
    Burns.2023; 49(6): 1403.     CrossRef
  • Treatment of Pediatric Upper Extremity Burns
    Carrie L. Roth Bettlach, Courtney Bergheger, Lauren Jacobson, Mitchell A. Pet
    The Journal for Nurse Practitioners.2023; 19(3): 104536.     CrossRef
  • Evaluation and Optimization of the Wallace Rule of Nines for the Estimation of Total Body Surface Area in Obese and Nonobese Populations
    Daniel Iván García-Ballesteros, Delia Del Carmen Rivera-Martínez, Mauricio Manuel García-Pérez, Everardo Valdés-Flores, Yanko Castro-Govea, Hernán Jesús Chacón-Moreno
    The Journal of Emergency Medicine.2023; 65(4): e320.     CrossRef
  • Clinical Profile of Children with Burns in a Tertiary Care Hospital
    AV Lalitha, K Yashaswini, GS Naresh Kanna, Abha Rani Kujur, John A Michael Raj
    Indian Journal of Critical Care Medicine.2023; 27(12): 934.     CrossRef
  • A 1% TBSA Chart Reduces Math Errors While Retaining Acceptable First-Estimate Accuracy
    William C Ray, Adrian Rajab, Hope Alexander, Brianna Chmil, Robert Wolfgang Rumpf, Rajan Thakkar, Madhubalan Viswanathan, Renata Fabia
    Journal of Burn Care & Research.2022; 43(3): 665.     CrossRef
  • Body mapping chart for estimation of percentage of body surface area in mesocephalic dogs
    Andrea Henriksson, Kendon Kuo, Katherine Gerken, Kelsey Cline, Adrien‐Maxence Hespel, Robert Cole, Rachel Moon
    Journal of Veterinary Emergency and Critical Care.2022; 32(3): 350.     CrossRef
  • The Nursing Effect of Different Dressings on Local Small Area Burn Wound
    娟 李
    Nursing Science.2022; 11(02): 279.     CrossRef
  • Integrating the Patient's Voice in Toxicity Reporting and Treatment Decisions for Breast Radiotherapy
    Sara R. Alcorn, Kimberly S. Corbin, Dean A. Shumway
    Seminars in Radiation Oncology.2022; 32(3): 207.     CrossRef
  • The relationships between routine admission blood tests and burn size, and length of stay in intensive care unit
    Eng-Kean Yeong, Kwang-Yi Tung, Chin-Hao Chang, Shang-Jie Tsai
    Journal of the Formosan Medical Association.2022; 121(12): 2512.     CrossRef
  • Estimation of percent body surface area in cats with use of computed tomography
    Andrea Henriksson, Jack Hamersky, Kendon Kuo, Katherine Gerken, Rachel Moon
    Journal of Veterinary Emergency and Critical Care.2022; 32(6): 743.     CrossRef
  • Effect of Different Itraconazole Dosing Regimens on Cure Rates, Treatment Duration, Safety, and Relapse Rates in Adult Patients With Tinea Corporis/Cruris
    Ananta Khurana, Aastha Agarwal, Diksha Agrawal, Sanjeet Panesar, Manik Ghadlinge, Kabir Sardana, Khushboo Sethia, Shalini Malhotra, Ankit Chauhan, Nirmala Mehta
    JAMA Dermatology.2022; 158(11): 1269.     CrossRef
  • Hallway Gait Monitoring System Using an In-Package Integrated Dielectric Lens Paired with a mm-Wave Radar
    Hajar Abedi, Jennifer Boger, Plinio Pelegrini Morita, Alexander Wong, George Shaker
    Sensors.2022; 23(1): 71.     CrossRef
  • To compare the effect of sea buckthorn and silver sulfadiazine dressing on period of wound healing in patients with second‐degree burns: A randomized triple‐blind clinical trial
    Mehrdad Abdullahzadeh, Saeed Shafiee
    Wound Repair and Regeneration.2021; 29(5): 732.     CrossRef
  • State of the Art: An Update on Adult Burn Resuscitation
    Jacqueline M. Causbie, Lauren A. Sattler, Anthony P. Basel, Garrett W. Britton, Leopoldo C. Cancio
    European Burn Journal.2021; 2(3): 152.     CrossRef
  • Lifetime Ambient UV Radiation Exposure and Risk of Basal Cell Carcinoma by Anatomic Site in a Nationwide U.S. Cohort, 1983–2005
    Mark P. Little, Terrence Lee, Michael G. Kimlin, Cari M. Kitahara, Rui Zhang, Bruce H. Alexander, Martha S. Linet, Elizabeth K. Cahoon
    Cancer Epidemiology, Biomarkers & Prevention.2021; 30(10): 1932.     CrossRef
Review
Surgery
Management of Critical Burn Injuries: Recent Developments
David J. Dries, John J. Marini
Korean J Crit Care Med. 2017;32(1):9-21.   Published online February 17, 2017
DOI: https://doi.org/10.4266/kjccm.2016.00969
  • 25,355 View
  • 1,537 Download
  • 3 Citations
AbstractAbstract PDF
Background
Burn injury and its subsequent multisystem effects are commonly encountered by acute care practitioners. Resuscitation is the major component of initial burn care and must be managed to restore and preserve vital organ function. Later complications of burn injury are dominated by infection. Burn centers are often called to manage problems related to thermal injury, including lightning and electrical injuries.
Methods
A selected review is provided of key management concepts as well as of recent reports published by the American Burn Association.
Results
The burn-injured patient is easily and frequently over resuscitated, with ensuing complications that include delayed wound healing and respiratory compromise. A feedback protocol designed to limit the occurrence of excessive resuscitation has been proposed, but no new “gold standard” for resuscitation has replaced the venerated Parkland formula. While new medical therapies have been proposed for patients sustaining inhalation injury, a paradigm-shifting standard of medical therapy has not emerged. Renal failure as a specific contributor to adverse outcome in burns has been reinforced by recent data. Of special problems addressed in burn centers, electrical injuries pose multisystem physiologic challenges and do not fit typical scoring systems.
Conclusion
Recent reports emphasize the dangers of over resuscitation in the setting of burn injury. No new medical therapy for inhalation injury has been generally adopted, but new standards for description of burn-related infections have been presented. The value of the burn center in care of the problems of electrical exposure, both manmade and natural, is demonstrated in recent reports.

Citations

Citations to this article as recorded by  
  • SUBMICROSCOPIC CHANGES IN THE HEMOCAPILLARIES OF THE CEREBRAL HEMISCLE CAUSES CAUSED BY THERMAL BURN
    H. V. Lukyantseva, V. A. Pastukhova, O. I. Kovalchuk
    Bulletin of Problems Biology and Medicine.2021; 3(1): 268.     CrossRef
  • Kefir Accelerates Burn Wound Healing Through Inducing Fibroblast Cell Migration In Vitro and Modulating the Expression of IL-1ß, TGF-ß1, and bFGF Genes In Vivo
    Ahmad Oryan, Esmat Alemzadeh, Mohammad Hadi Eskandari
    Probiotics and Antimicrobial Proteins.2019; 11(3): 874.     CrossRef
  • Viable placental allograft as a biological dressing in the clinical management of full-thickness thermal occupational burns
    Eric L. Johnson, Elisabet K. Tassis, Georgina M. Michael, Susan G. Whittinghill
    Medicine.2017; 96(49): e9045.     CrossRef
Original Article
Diagnosis of Acid-base Imbalance by Stewart's Physicochemical Approach and Mortality Prediction in Severe Burn Patients with Inhalation Injury
Sunghoon Park, Cheol Hong Kim, In Gyu Hyun, Ki Suck Jung
Korean J Crit Care Med. 2006;21(1):17-27.
  • 2,316 View
  • 55 Download
AbstractAbstract PDF
BACKGROUND
Acid-base derangement are commonly encountered in critically ill patients. This study is to investigate underlying mechanisms of acid-base imbalance and also to examine whether they can predict mortality in burn patients.
METHODS
We retrospectively reviewed 73 severely burned patients who had admitted to burn intensive care unit, from January to July in 2004. All the patients had inhalation injury, identified by bronchoscopic examination. We analyzed the type and nature of the acid-base imbalances from arterial blood gas analysis, electrolytes and other biological tests between survivors and non-survivors for 30 days after admission.
RESULTS
Acidosis was the most common disorder during the early and late hospital periods. Large fractions of those showed decreased strong ion difference (SID), increased anion gap corrected by albumin (AGc) and [Cl-]corrected. Mixed disorder and alkalosis emerged after the 7(th) hospital day. As time went by, albumin, PaO2/FiO2 ratio, pH and SID were more decreased in non-survivors (n=28) than in survivors (n=45) while [Cl-] corrected, alveolar-arterial oxygen tension gradients, peripheral WBC counts and CRP were more increased in non-survivors than in survivors. In the area under the receiver operating characteristic curves for mortality prediction, APACHE II score and % of total body surface area (%TBSA) burn were high: 0.866 (95% CI; 0.785~0.946) for APACHE II score, 0.817 (95% CI; 0.717~0.918) for %TBSA burn.
CONCLUSIONS
In burned patients with inhalation injury, various types of acid-base imbalances and electrolytes abnormalities emerged after resuscitation and so, more careful attentions pursued for correcting underlying acid-base derangement.

ACC : Acute and Critical Care