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The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.
The score is an index which takes into account the correlative and causal relationship between mortality and factors including advancing age, burn size, the presence of inhalational injury. [2] Studies have shown that the Baux score is highly correlative with length of stay in hospital due to burns and final outcome. [3]
The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn.In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.
Total body surface area (TBSA) is an assessment of injury to or disease of the skin, such as burns or psoriasis. In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body. [1]
[1] [2] [3] The milliliter amount of fluid required for the first 24 hours – usually Lactated Ringer's – is four times the product of the body weight and the burn percentage (i.e. body surface area affected by burns). [4] The first half of the fluid is given within eight hours from the burn incident, and the remaining over the next 16 hours.
Patients with uncomplicated burns have a 99.7% survival rate. Three risk factors—patient age above 60, burns covering more than 40% of the body, and inhalation injury—greatly reduce the odds of survival, which decline to 97% with any one of these complications, to 67% with any two, and to only 10% in cases with all three.
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a) Fasciotomy and b) Escharotomy in a child with third degree burns. A motorized dermatome is used to make the incisons. An escharotomy is a surgical procedure used to treat full-thickness (third-degree) circumferential burns. In full-thickness burns, both the epidermis and the dermis are destroyed along with sensory nerves in the dermis.