The total body surface area of a burn is critical to estimate the amount of fluid needed to resusitate a burn patient per the parkland formula. To estimate the total body surface area the physician relies on a clinical estimation per rule of nine’s or assuming that the palm represent’s 1% of the total body surface area and guessing the approximate number of palm’s that it would take to cover the burn. The surfaces burned are recorded on a two dimensional “Lund & Browder “chart. Any inaccuracies can lead to under resuscitating with possible renal failure or massive fluid overload, pulmonary edema and death.
A 3DMD burns software application was developed to allow the user to display 3D surfaces, markup burns by degree and take measurements from them. The Total body surface area burned is then calculated and is automatically entered into the Parkland formula. The amount of fluid needed for resusitation is computed.
On the initial burn day seven patients were imaged using the Digital Surface Photogrammetry (DSP), DSP100 imager by 3DMD, Tricorder Technology, Atalanta, GA and The UK). The Total body surface area was calculated with the 3DMD, DSP 1000 software. The burn surfaces were measured directly and the patients total body surface area were measured directly and compared to the Lund & Browder diagram and the 3D imager.
Seven male burn victims underwent total body three Dimensional imaging as part of their initial burn assessment. The wounds were cleansed and debrided before imaging. The average total body surface area was 28,500cm2 by the imager and 25,000cm2 by direct measurement. The average Total body surface area burned ranged from 5-30% burn. The percentage burn calculated from the 3D imager was 98% accurate when compared to direct measurement. The percentage burn calculated by the Lund & Browder method was 70% accurate when compared to direct measurement.
The total body surface area with the correct percentage burn can be quickly calculated and documented by 3D imaging. The 3D imager is a more accurate estimation of total body surface area burned than the Lund-Browder Chart.