Body Surface Area Diagram: Comprehensive Guide to Determining Total Body Surface Area (TBSA)

11.07.202214.07.2023 by alexxlab

How is Total Body Surface Area calculated. What are the primary methods for assessing TBSA. Why is TBSA important in burn treatment. How accurate are different TBSA calculation methods. What new technologies are improving TBSA assessment.

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Understanding Total Body Surface Area (TBSA) in Burn Assessment

Total Body Surface Area (TBSA) is a crucial metric used by medical professionals to evaluate the severity of burn injuries. It plays a pivotal role in determining the appropriate treatment course, including fluid resuscitation, transfer decisions, and overall patient management. Accurate TBSA assessment is essential for providing optimal care to burn patients and improving their prognosis.

There are three primary methods used to calculate TBSA:

Lund and Browder Chart
Wallace Rule of Nines
Palmer Method

Each of these methods has its own strengths and limitations, which we will explore in detail throughout this article.

The Lund and Browder Chart: Precision in TBSA Calculation

The Lund and Browder (LB) chart is widely regarded as the most accurate method for calculating TBSA. This chart provides detailed anterior and posterior diagrams of the human body, with each region assigned a specific percentage ranging from 1% to 13%.

How does the Lund and Browder chart work?

Medical professionals examine the burn injury and add up the percentages of each affected body region to determine the total TBSA. This method allows for a more nuanced assessment, taking into account variations in body proportions between adults and children.

Advantages of the Lund and Browder chart:

High accuracy in TBSA calculation
Accounts for differences in body proportions
Provides a comprehensive visual representation of burn areas

Limitations of the Lund and Browder chart:

Requires quick mental calculations
May lead to discrepancies between different medical staff members
Can be time-consuming in emergency situations

The Wallace Rule of Nines: Rapid TBSA Assessment for Severe Burns

The Wallace Rule of Nines is a popular method for assessing second- and third-degree burn injuries. This approach divides the body into sections, each representing a multiple of 9% of the total body surface area.

How is the Wallace Rule of Nines applied?

In adults, the body is divided as follows:

Each arm: 9%
Each leg: 18%
Anterior torso: 18%
Posterior torso: 18%
Head: 9%
Genitalia/Perineum: 1%

Medical professionals can quickly sum up the affected areas to determine the total TBSA burned.

Advantages of the Wallace Rule of Nines:

Simple and easy to remember
Allows for rapid assessment in emergency situations
Facilitates quick communication of burn extent among medical team members

Limitations of the Wallace Rule of Nines:

Less accurate for children due to different body proportions
May not account for variations in individual body types
Can lead to overestimation or underestimation in certain cases

The Palmer Method: A Quick Estimate for Small Burns

The Palmer Method uses the patient’s own palm as a reference measurement for calculating burn size. This approach is particularly useful for assessing smaller burn areas.

How does the Palmer Method work?

The length of the patient’s palm from wrist to fingertip is considered to represent approximately 1% of their total body surface area. By comparing the burn area to the size of the patient’s palm, medical professionals can quickly estimate the TBSA affected.

Advantages of the Palmer Method:

Fast and easy to use in the field
Requires no special equipment or charts
Useful for initial assessments of small burns

Limitations of the Palmer Method:

Can lead to overestimation of burn size by 10-20%
Less accurate for larger burns or multiple burn sites
Variation in hand size relative to body size can affect accuracy

Comparing TBSA Assessment Methods: Accuracy and Applicability

While each method has its merits, it’s important to understand their relative accuracy and best use cases.

Which method is most accurate for TBSA calculation?

The Lund and Browder chart is generally considered the most accurate method for TBSA calculation. Its detailed body map and age-specific adjustments allow for more precise assessments, particularly in pediatric cases.

When is the Wallace Rule of Nines most appropriate?

The Wallace Rule of Nines is particularly useful in emergency situations where rapid assessment is critical. It’s best suited for adults with second- or third-degree burns covering large areas of the body.

What are the ideal scenarios for using the Palmer Method?

The Palmer Method is most effective for quick estimates of small burns, especially in pre-hospital or triage settings. It’s a valuable tool for first responders and emergency medical technicians who need to make rapid initial assessments.

The Impact of TBSA Assessment on Burn Treatment

Accurate TBSA calculation is crucial for determining the appropriate course of treatment for burn patients. It influences several key aspects of burn care:

How does TBSA affect fluid resuscitation?

TBSA is a critical factor in calculating the amount of intravenous fluid a burn patient requires. Overestimation or underestimation of TBSA can lead to inadequate or excessive fluid administration, both of which can have serious consequences.

What role does TBSA play in transfer decisions?

Patients with burns covering more than 20% TBSA (or 10% in children) are typically transferred to specialized burn centers. Accurate TBSA assessment ensures that patients receive the appropriate level of care in the right facility.

How does TBSA influence long-term prognosis and treatment planning?

TBSA is a key factor in predicting burn outcomes and planning long-term treatment strategies. It helps medical professionals anticipate potential complications and develop comprehensive rehabilitation plans.

Advancements in TBSA Assessment: The Role of Technology

As medical technology evolves, new tools are emerging to improve the accuracy and efficiency of TBSA calculations.

How are 3D models enhancing TBSA assessment?

Advanced 3D modeling technologies are now being used to create more accurate representations of human anatomy. These digital models can be manipulated to match a patient’s body type and burn patterns, potentially improving the precision of TBSA calculations.

What mobile applications are available for TBSA calculation?

Several smartphone apps have been developed to assist medical professionals in calculating TBSA. These apps often incorporate multiple assessment methods and can quickly generate accurate TBSA estimates based on user input.

How might artificial intelligence impact future TBSA assessments?

Artificial intelligence and machine learning algorithms are being explored for their potential to analyze burn images and provide rapid, accurate TBSA calculations. These technologies could help standardize assessments and reduce human error.

Beyond TBSA: Holistic Approaches to Burn Care and Recovery

While TBSA is a crucial metric in burn treatment, it’s important to recognize that burn care extends far beyond initial assessments.

What psychological support is essential for burn survivors?

Burn injuries can have significant psychological impacts. Comprehensive burn care should include access to mental health professionals, support groups, and resources to help patients cope with the emotional aspects of their recovery.

How can burn survivors build a supportive community?

Organizations like the Phoenix Society offer resources and community connections for burn survivors. These networks can provide invaluable peer support, shared experiences, and practical advice for navigating the challenges of burn recovery.

What role does ongoing education play in burn recovery?

Continuous education about burn care, scar management, and rehabilitation techniques is crucial for both patients and their caregivers. Access to up-to-date information can significantly improve long-term outcomes and quality of life for burn survivors.

In conclusion, while accurate TBSA assessment is a critical first step in burn treatment, it’s part of a broader, multifaceted approach to care. By combining precise medical assessments with comprehensive support and ongoing education, we can continue to improve outcomes for burn survivors and help them on their journey to recovery.

Defining Total Body Surface Area (TBSA)

Article

Written on April 19, 2022

Accessibility

Burn Treatment

Burn Wounds

Getting Quality Treatment

Optimal Burn Care

One of the most common phrases you’re likely to come across throughout the burn treatment process is total body surface area (TBSA). TBSA is a tool medical professionals use to assess the severity of a patient’s burns. The speed and accuracy of this initial assessment is critical because it informs all steps of the patient healthcare journey, including fluid resuscitation, transfer decisions, management, prognosis, and research.

There are three primary methods of calculation. Each has its own grading system, use case, and pros and cons. In this article, we’ll take a closer look at these three methods of assessing TBSA. Equip yourself with the knowledge you need to understand and ask questions about your treatment and recovery.

How Is the Total Body Surface Area Determined?

To calculate TBSA, doctors and nurse practitioners focus on three main methods: Lund and Browder, Wallace Rule of Nines, and the Palmer Method.

Lund and Browder Chart

The first method of burn assessment uses the Lund and Browder (LB) chart. The LB chart shows both anterior and posterior diagrams of the human body and assigns percentages to each region of the body, from 1-13 percent. As medical staff members examine the burn injury, they add up the percentages of each body region to calculate the severity of all injuries.

Lund and Browder is considered the most accurate of these three methods, but the LB chart still has its limitations. This method requires quick mental calculation. Ease of use is also a concern as medical staff members may come up with different TBSA calculations. This is why it’s so important that TBSA formulas are precise, reliable, and repeatable.

Wallace Rule of Nines

The Wallace Rule of Nines is most often used for second- and third-degree burn injuries. Every burned portion of the body is counted by a multiple of nine. Each arm, for example, is assigned 9 percent; each leg is assigned 18 percent. A doctor or nurse practitioner can quickly add up the total body surface burned based on an initial visual examination. The table below from Healthline shows the Rule of Nines percentage points for adults:

The advantage of using the Wallace Rule of Nines is that the estimation is a simple formula, and, therefore, it is easy to calculate the amount of fluid replacement (IVs) and level of care a patient will require. It offers quick assessments in emergency situations and empowers medical professionals to quickly relay burn injury measurements to the rest of the team. Because burn injuries with a percentage of 30-plus percent can be fatal, a quick response is critical.

Palmer Method

The third method is known as the Palmer Method. Medical staff use the length of the patient’s palm (fingers together), not their own, as a reference measurement for calculating burn size and span. The length from wrist to finger = 1 percent TBSA.

On one hand, the Palmer Method makes it easy to calculate quickly and assess a patient’s fluid resuscitation and care needs. On the other hand, the Palmer Method is far from perfect science. In fact, the average adult’s hand makes up 0.78 percent of their total body surface area. In most children, that same number is more than 1 percent. For this reason, the Palmer Method can lead to burn injury overestimations of anywhere from 10-20 percent. It’s important to remember that the Palmer Method is only a rough initial estimate and is best used for small burns.

Methods of TBSA assessment continue to improve, thanks to 3D technology. Medical teams now have access to 3D models of human anatomy on desktop and mobile applications to quickly and accurately assess burn injuries. Full rollout and implementation is still in the works in hospitals and burn centers throughout the United States.

TBSA is just one of the first steps toward burn diagnostics, treatment, and recovery. Burn survivors can take additional steps on their own toward understanding, acceptance, and community-building as they come to terms with their injury on the road to healing.

Phoenix Society offers a full library of resources from survivors and medical experts who understand what you’re going through. Looking for added support as you navigate the treatment and recovery process? Reach out today.

Estimating body surface area – WikEM

1 Rule of Nines
2 Rule of Palms
3 Lund-Browder Classification
4 See Also
5 References

Rule of Nines

**Adults**
Anatomic structure	Surface area
Anterior Head	4.5%
Posterior Head	4.5%
Anterior Torso	18%
Posterior Torso	18%
Each Anterior Leg	9%
Each Posterior Leg	9%
Each Anterior Arm	4.5%
Each Posterior Arm	4.5%
Genitalia/Perineum	1%

**Children**
Anatomic structure	Surface area
Anterior Head	9%
Posterior Head	9%
Anterior Torso	18%
Posterior Torso	18%
Each Anterior Leg	6. 5%
Each Posterior Leg	6.5%
Each Anterior Arm	4.5%
Each Posterior Arm	4.5%
Genitalia/Perineum	1%

Rule of Palms

Patient’s entire hand (palm+fingers) = about 1% TBSA
Use to estimate scatter burns
Also use for local burns up to 10% BSA

Lund-Browder Classification

Lund Browder Chart to document initial TBSA assessment.

An alternative method of estimate burn surface area

More accurate than “Rule of Nines,” especially in pediatric patients

**Children**
Anatomic structure	0 Yr	1 Yr	5 Yrs	10 Yrs	15 Yrs
Anterior Head	9.5%	8.5%	6.5%	5.5%	4.5%
Posterior Head	9.5%	8.5%	6.5%	5. 5%	4.5%
Anterior Neck	1%	1%	1%	1%	1%
Posterior Neck	1%	1%	1%	1%	1%
Anterior Torso	13%	13%	13%	13%	13%
Posterior Torso	13%	13%	13%	13%	13%
Each Anterior Upper Leg	2.75%	3.25%	4%	4.25%	4.5%
Each Posterior Upper Leg	2.75%	3.25%	4%	4.25%	4.5%
Each Anterior Lower Leg	2.5%	2.5%	2.75%	3%	3.25%
Each Posterior Lower Leg	2.5%	2.5%	2.75%	3%	3.25%
Each Anterior Upper Arm	2%	2%	2%	2%	2%
Each Posterior Upper Arm	2%	2%	2%	2%	2%
Each Anterior Lower Arm	1. 5%	1.5%	1.5%	1.5%	1.5%
Each Posterior Lower Arm	1.5%	1.5%	1.5%	1.5%	1.5%
Each Anterior Hand	1.5%	1.5%	1.5%	1.5%	1.5%
Each Posterior Hand	1.5%	1.5%	1.5%	1.5%	1.5%
Each Anterior Foot/Ankle	1.75%	1.75%	1.75%	1.75%	1.75%
Each Posterior Foot/Ankle	1.75%	1.75%	1.75%	1.75%	1.75%
Each Buttock	2.5%	2.5%	2.5%	2.5%	2.5%
Genitalia/Perineum	1%	1%	1%	1%	1%

References

Authors:

Ross Donaldson
Jaskaran Singh
Claire
Jonathon Keast

Calculation of the surface area of complex parts

Author :

Danilko Vladimir Andreevich

Supervisor :

Kostrova Yulia Sergeevna

Category : Mathematics

Posted by
V

young scientist

#16 (411) April 2022

Publication date : 19. 04.2022
2022-04-19

Article viewed:

734 times

Download electronic version

Download Part 1 (pdf)

References:

Danilko, V. A. Calculation of the surface area of complex parts / V. A. Danilko. – Text: direct // Young scientist. – 2022. – No. 16 (411). – P. 4-7. — URL: https://moluch.ru/archive/411/

/ (date of access: 07/14/2023).

The paper analyzes methods for measuring the surface area of various figures. The author’s method for calculating the surface area of a figure as a surface area of rotation with a preliminary analytical description of the contour of the figure is presented.

Keywords: surface area of revolution, integrals, bodies of complex shape.

To solve certain types of electroplating and metalworking tasks, it is required to know the surface area of the body with which you will have to work. However, it is not always possible to quickly carry out calculations, due to the fact that some parts have an atypical, complex shape. Therefore, it becomes necessary to find the simplest, most convenient and cost-effective way to determine this area.

There are various approaches to solving this problem. For example, Yaskelyain B.V. and Cherednechenko T.F. proposed a method for measuring the surface area of a body, in which a film of a material of constant thickness with the property of hygroscopicity is applied to the body, after covering the surface with a wetting composition. At the same time, the surface area is found from its geometric area, taking into account the ratio of the increment in the length of the film to the geometric length of the surface [1].

Another method was proposed by V. G. Vokhmyanin [2]. It consisted in measuring the weight of two bodies, a simple reference (exemplary) and a measured (complex shape). First, under normal conditions, the weight of the bodies was measured, and then they were cooled to the water condensation temperature and weighed again. The area was calculated by finding the quotient from dividing the change in the weight of the measured body by the change in the weight of the reference. In this case, the resulting number is the surface area expressed in units of the reference body. This method, compared with similar ones, is characterized by high performance, simplicity, low cost and high accuracy.

The method for measuring the surface area proposed by V.S. Akselrod and G.M. Rokhlina [3] makes it possible to measure the area of a flat part of a complex shape and is based on measuring the capacitance of a capacitor. The area of the product is equal to the product of the ratio of the capacitance of the capacitors, one of the plates of which is the measured product or the reference product.

ED Grazhdannikov proposed a method for determining the magnitude of the surface of solids, based on measuring the reduction in the times of spin-lattice and spin-spin magnetic relaxation of nuclei in a liquid layer covering the surface of the solid phase [4]. This method is designed to determine the surface of a wide range of applied substances and carriers, and measurements can be taken directly in the course of the reaction. To determine the surface area by this method, a product standard is needed, the surface area of which can be measured in another way.

B. D. Razuvaeva and K. S. Lytkin, studying methods for determining the surface area of complex products, came to the conclusion that the dissolution method is quite reliable in measuring the surface area of a part [5]. It is based on the fact that the amount of metal dissolved in a liquid per unit of time is proportional to the size of the metal surface. To determine the surface area by this method, a reference product with a known surface area is required.

Each of the presented methods involves the implementation of certain chemical operations with the product, and often the presence of a reference body. At the same time, turning to mathematical tools, it is possible to calculate the surface area of the body analytically at lower cost.

For example, if a product has central symmetry, then it can be considered as a body of revolution. Then its surface area can be calculated as the surface area of rotation by the formula:

2 ₂ – borders, in which the function is defined.

Consider a more detailed application of this method on a particular example. Let’s determine the surface area of a chess pawn (Fig. 1.).

Fig. 1. Chess pawn

Let’s place the contour of the investigated body in the XOY Cartesian coordinate system (Fig. 2.).

Different sections of the contour can be defined with different view functions. So it is possible to select 8 such functions that define the contour of the lateral surface for 8 sections. Since we are looking for the area of the lateral surface, we do not consider the area of \u200b\u200bthe base of the figure.

1) With – function –

2) With – function –

3) With – function –

4) With – function –

5) With – function –

6) With – function –

7) With – function –

9000 2 8) At – function –

Fig. 2. Pawn contour in the coordinate system

Having found these functions, we can calculate the surface area of these sections. In situations where the function has the form , the surface area of the section will be calculated in the same way as the surface area of the cylinder, according to the formula, but in this case – , and , where and are the coordinates of the beginning and end of the section, respectively.

So, for the first and fourth sections, the surface area is respectively: , .

For other sections, the formula will be used to calculate the surface area of rotation along the OX axis.

This is how we calculate the surface area of the second section:

Further, similarly, we obtain the values of the surface area of the remaining sections:

, , , , .

The final surface area is found as the sum of the surface areas of the plots:

This method can be used to determine the surface area of bodies along with those previously mentioned. It will be especially convenient if the product has central symmetry. The method is distinguished by accuracy and economic benefits.

Literature:

1. Yaskelyain B. V., Cherednenko T. F. A method for measuring the surface area of a body of complex shape [Electronic resource] // NEB: National Electronic Library — URL: https://rusneb.ru/catalog/ 000224_000128_0093005691_19950720_A_RU/ (accessed 22.02.2022)

2. Vokhmyanin V. G. V. G. Vokhmyanin’s method for measuring the surface area of a body of complex shape [Electronic resource] // FREEPATENT: patent search in the Russian Federation — URL: https:// www .freepatent.ru/patents/2040776 (accessed 02/22/2022)

3. Akselrod V. S., Rokhlina G. M. Method for determining the surface area of electrically conductive products [Electronic resource] // NEB: National Electronic Library — URL: https://viewer.rusneb.ru/ru/000224_000128_0000273447_19700615_A1_SU?page=1&rotate=0&theme=white (accessed 22.02.2022)

4. Grazhdannikov E. D. Method for determining the surface area of solids [Electronic resource] // NEB: National Electronic Library — URL: https://viewer .rusneb.ru/ru/000224_000128_0000176457_19651102_A1_SU? Page = 1 & Rotate = 0 & Theme = White (date of 02.22.2022)

5. Razuvaeva B. D., Lytkin K. S. express Method of Krivoline’s measurement and fact Tour surfaces [Electronic resource] // Precious materials – URL: http://jewelpreciousmetal.ru/technology_other_surfacearea.php ((Accessed 02/22/2022)

Basic terms (automatically generated) : surface area, complex shape, function, surface area of revolution, XOY, lateral surface, central symmetry, chess pawn, reference product, reference body.

Keywords

surface area of rotation,

integrals,

bodies of complex shape

surface area of revolution, integrals, bodies of complex shape

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