Body surface area diagram: Determining Total Body Surface Area
Defining Total Body Surface Area (TBSA)
Article
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 Calculator
The calculator below computes the total surface area of a human body, referred to as body surface area (BSA). Direct measurement of BSA is difficult, and as such many formulas have been published that estimate BSA. The calculator below provides results for some of the most popular formulas.
RelatedArea Calculator | Surface Area Calculator
Table of average BSAs
BSA is often used in clinical purposes over body weight because it is a more accurate indicator of metabolic mass (the body’s need for energy). Metabolic mass can be estimated using fat-free mass, where fat-free mass is all of a person’s body mass that does not include fat. This includes bones, tendons, inner organs, muscles, blood, nerves, and more. Since body fat is not metabolically active and fat-free mass excludes body fat, fat-free mass is a reasonable estimate of metabolic mass.
BSA is also used in various other clinical settings, such as determining cardiac index (to relate a person’s heart performance to their body size) or most commonly, dosages for chemotherapy (a category of cancer treatment). While dosing for chemotherapy is often determined using a patient’s BSA, there exist arguments against the use of BSA to determine medication dosages that have a narrow therapeutic index – the comparison of the amount of a substance necessary to produce a therapeutic effect, to the amount that causes toxicity. If the therapeutic index is too narrow, BSA may not be an accurate enough measure, and there is a risk of causing a toxic rather than therapeutic effect. There is also evidence that BSA becomes less accurate at the extremes of height and weight, and BMI may be a better estimate in such cases. Despite these limitations, the effects of chemotherapy dosages as determined by BSA measurements still remain more consistent than those determined by body weight alone.
Below are some of the most popular formulas for estimating BSA, and links to references for each for further detail on their derivations. The most widely used of these is the Du Bois formula, which has been shown to be effective for estimating body fat in both obese and non-obese patients, unlike body mass index. Where BSA is represented in m2, W is weight in kg, and H is height in cm, the formulas are as follows:
Du Bois formula:
BSA = 0.007184 × W0.425 × H0.725
Du Bois D, Du Bois EF (Jun 1916). “A formula to estimate the approximate surface area if height and weight be known”. Archives of Internal Medicine 17 (6): 863-71. PMID 2520314. Retrieved 2012-09-09.
Mosteller formula:
BSA = = 0.016667 × W0.5 × H0.5
Mosteller RD. “Simplified calculation of body-surface area”. N Engl J Med 1987; 317:1098. PMID 3657876.
Haycock formula:
BSA = 0. 024265 × W0.5378 × H0.3964
Haycock GB, Schwartz GJ, Wisotsky DH “Geometric method for measuring body surface area: A height-weight formula validated in infants, children and adults” J Pediatr 1978, 93:62-66.
Gehan and George formula:
BSA = 0.0235 × W0.51456 × H0.42246
Gehan EA, George SL, Cancer Chemother Rep 1970, 54:225-235
Boyd formula:
BSA = 0.03330 × W(0.6157 – 0.0188 × log10(W) × H0.3
Boyd, Edith (1935). The Growth of the Surface Area of the Human Body. University of Minnesota. The Institute of Child Welfare, Monograph Series, No. x. London: Oxford University Press
Fujimoto formula:
BSA = 0.008883 × W0.444 × H0.663
Fujimoto S, Watanabe T, Sakamoto A, Yukawa K, Morimoto K. Studies on the physical surface area of Japanese. 18. Calculation formulae in three stages over all ages. Nippon Eiseigaku Zasshi 1968;5:443-50.
Takahira formula:
BSA = 0. 007241 × W0.425 × H0.725
Fujimoto S, Watanabe T, Sakamoto A, Yukawa K, Morimoto K. Studies on the physical surface area of Japanese. 18. Calculation formulae in three stages over all ages. Nippon Eiseigaku Zasshi 1968;5:443-50.
Schlich formula:
Women BSA = 0.000975482 × W0.46 × H1.08
Men BSA = 0.000579479 × W0.38 × H1.24
Schlich E, Schumm M, Schlich M: “3-D-Body-Scan als anthropometrisches Verfahren zur Bestimmung der spezifischen Korperoberflache”. Ernahrungs Umschau 2010;57:178-183
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/
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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