Body surface area diagram: Determining Total Body Surface Area

11.07.202214.07.2023 by alexxlab

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Defining Total Body Surface Area (TBSA)

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Written on April 19, 2022

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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.

Body Surface Area – StatPearls

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StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-.

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Bronson Flint; Carrie A. Hall.

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Last Update: March 25, 2023.

Definition/Introduction

Body surface area was developed as a metric to use in the modulation of various pharmacological therapies and a standard tool by which to index various physiologic measurements such as glomerular filtration rate and cardiac output. There exist many variations in formulae to calculate an individual’s body surface area, but one of the most widely used techniques to calculate this value is the Du Bois and Du Bois formula. The formula is as follows[1]:

Issues of Concern

A predominant area of concern in calculating body surface area is that many different equations are used in the calculation. As such, some of the equations may yield vastly different results from others. In the clinical context, this presents a significant challenge. For example, body surface area is used to calculate the dosing regimen for many medications to ensure the medication’s therapeutic window is maintained and adverse effects avoided. Significant variances in body surface area calculations potentially result in over or underdosing of drugs and failure to obtain the targeted effects of the drug.[2]

Clinical Significance

The body surface area metric holds a significant place in both pharmacology and physiologic data measurement. Body surface area is most commonly used to guide the dosing of chemotherapeutic drugs. Early chemotherapy research found that the effects of these cancer treatments were much more consistent among individuals when dosed according to body surface area as opposed to body weight alone. [3]

Body surface area is also useful to assess the degree of severity in severe burn injury patients. It is crucial to accurately assess the percentage of total body surface area that a patient has sustained burns to stratify the severity best and guide the management of patients with burn injuries.[4] Physiologic information can be calculated in part using body surface area.

Another essential use of body surface area is in calculating a patient’s cardiac index, a measure of the physiologic status of cardiac function. The formula for the cardiac index is (liters/min)/(body surface area).[5] Further, the use of clinical tools, such as nomograms, utilizes the patient’s height and weight displayed graphically to calculate their body surface area as well.

Nursing, Allied Health, and Interprofessional Team Interventions

Clinical teams managing patients in hospital units or clinics that administer and manage chemotherapy treatment regimens should possess a sound understanding of how to calculate body surface area. It should be a routinely observed metric for any patient under the care of a chemotherapy treatment plan. Furthermore, clinical providers, nursing staff, and allied healthcare workers who work in burn injury units should also develop an understanding of the calculation of body surface area and its implications, specifically in the management of burn injuries.

Nursing, Allied Health, and Interprofessional Team Monitoring

In summary, all staff caring for patients should understand how to calculate the body surface area. In patient populations in which its utility is particularly underscored, this skill is even more vital. Furthermore, physicians, medical students, and nurses need to comprehend the significance of body surface area as it relates to chemotherapy, meter the severity of burn injuries, and understand physiologic parameters.

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References

1.: Burton RF. Estimating body surface area from mass and height: theory and the formula of Du Bois and Du Bois. Ann Hum Biol. 2008 Mar-Apr;35(2):170-84. [PubMed: 18428011]
2.: Sigurdsson TS, Lindberg L. Six commonly used empirical body surface area formulas disagreed in young children undergoing corrective heart surgery. Acta Paediatr. 2020 Sep;109(9):1838-1846. [PubMed: 32010999]
3.: Kaestner SA, Sewell GJ. Chemotherapy dosing part I: scientific basis for current practice and use of body surface area. Clin Oncol (R Coll Radiol). 2007 Feb;19(1):23-37. [PubMed: 17305252]
4.: Retrouvey H, Chan J, Shahrokhi S. Comparison of two-dimensional methods versus three-dimensional scanning systems in the assessment of total body surface area estimation in burn patients. Burns. 2018 Feb;44(1):195-200. [PubMed: 28797577]
5.: Patel N, Durland J, Makaryus AN. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Sep 26, 2022. Physiology, Cardiac Index. [PubMed: 30969727]

: Disclosure: Bronson Flint declares no relevant financial relationships with ineligible companies.
: Disclosure: Carrie Hall declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
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http://creativecommons.org/licenses/by-nc-nd/4.0/
), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

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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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Body surface area diagram: Determining Total Body Surface Area

Defining Total Body Surface Area (TBSA)

How Is the Total Body Surface Area Determined?

Lund and Browder Chart

Wallace Rule of Nines

Palmer Method

Body Surface Area – StatPearls

StatPearls [Internet].

Definition/Introduction

Issues of Concern

Clinical Significance

Nursing, Allied Health, and Interprofessional Team Interventions

Nursing, Allied Health, and Interprofessional Team Monitoring

Review Questions

References

In this Page

Bulk Download

Related information

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