Utility of palm and hand surface area in approximating burn extent in Burundian adults and children

Abstract

The use of palm and hand surface areas to approximate the extent of burns is as widespread as it is facile. However, direct comparison of measured palm and hand surface areas to total body surface areas (TBSA) have demonstrated variable accuracy in different patient populations. We measured the palm and hand surface areas of 353 Burundian adults and children, including 23 underweight children and compared those values with 0.5% and 1%, respectively, of the calculated TBSA via Mosteller, Dubois, and Haycock formulae. We used Student’s t-test to analyze for significant departure from predicted values. For 100 Burundian adults with a median BMI of 21.7 the palm and hand surface areas represented 0.40% and 0.77% TBSA, respectively. For 253 Burundian children, the mean palm and hand surface are represented 0.44% and 0.86% TBSA, respectively. Subgroup analysis of underweight children (BMI < 18.5 or Z-score ≤−2 weight for height) revealed values of 0.45% and 0.88% for palm and hand areas. Our data indicate that using values of 0.5% TBSA for the palm and/or 1% TBSA for the hand overestimates the actual burn extent and would be improved with a correction factor for Burundian patients.