Amirsheybani H R, Crecelius G M, Timothy N H, Pfeiffer M, Saggers G C, Manders E K
Department of Surgery, the Pinnacle Health System, Department of Psychiatry, University of California at Los Angeles, USA.
Plast Reconstr Surg. 2001 Mar;107(3):726-33. doi: 10.1097/00006534-200103000-00012.
The use of a patient's own hand as a tool to estimate the area of burn injury is well documented. The area of the palmar surface of one hand has been estimated to be 1 percent of the body surface area. The area of the palmar surface of the hand was measured to test the accuracy of this estimate and then compared with the body surface area as calculated by formulas in common use. This study also sought to determine the natural history of the growth of the hand to permit development of a readily available, bedside means of estimating hand area and body surface area. Bilateral hand tracings were obtained from 800 volunteers ranging in age from 2 to 89 years. The area of each tracing was determined using an integrating planimeter. The height and weight of each individual were measured, and his/her body surface area was calculated. The palmar hand's percentage of body surface area was determined by calculating the quotient for hand area divided by body surface area. Additionally, the width of the hand was measured from the ulnar aspect at the palmar digital crease of the small finger to the point where the thumb rested against the base of the index finger. The length of the hand was measured from the middle of the interstylon to the tip of the middle finger. These two figures were multiplied together to obtain a product which approximated the area of the hand. Based on the most commonly used DuBois formula for calculating body surface area, the area of palmar surface of the hand corresponds to 0.78 +/- 0.08 percent of the body surface area in adults. The percentage varies somewhat with age and reaches a maximum of 0.87 +/- 0.06 percent in young children. Multiplying the length of the hand by its width overestimates the area of the hand as determined by planimetry by only 2 percent. A patient's own hand may be used as a complementary, readily available template for estimation of burn area or other areas of disease or injury. In adults, the area of tracing of the outline of the hand is 0.78 percent of the body surface area, whereas in children, this number tends to be slightly higher. In the emergency room or on the wards, a simple product of length multiplied by width of the hand will closely approximate the area as determined by planimetry. This method allows a more accurate determination of the area of the palmar surface of the hand than the 1 percent estimate, which may lead to an overestimation of the size of a burn wound in adults.
使用患者自己的手作为估计烧伤面积的工具已有充分记录。一只手掌面的面积估计占体表面积的1%。测量手掌面的面积以测试该估计的准确性，然后与常用公式计算出的体表面积进行比较。本研究还试图确定手生长的自然史，以便开发一种随时可用的床边估计手面积和体表面积的方法。从800名年龄在2至89岁的志愿者身上获取了双侧手部描图。使用积分求积仪确定每个描图的面积。测量每个个体的身高和体重，并计算其体表面积。通过计算手部面积除以体表面积的商来确定手掌占体表面积的百分比。此外，测量手的宽度，从小指掌指关节处的尺侧到拇指抵靠食指基部的点。测量手的长度，从桡腕关节中点到中指指尖。将这两个数字相乘得到一个近似手部面积的乘积。根据最常用的计算体表面积的杜波依斯公式，成年人手掌面的面积相当于体表面积的0.78±0.08%。该百分比随年龄略有变化，在幼儿中最高可达0.87±0.06%。将手的长度乘以宽度得出的面积比用求积仪测量得出的面积仅高估2%。患者自己的手可作为一种补充的、随时可用的模板，用于估计烧伤面积或其他疾病或损伤区域。在成年人中，手部轮廓描图的面积占体表面积的0.78%，而在儿童中，这个数字往往略高。在急诊室或病房，简单地将手的长度乘以宽度所得结果将非常接近用求积仪测量得出的面积。与1%的估计相比，这种方法能更准确地确定手掌面的面积，1%的估计可能会高估成年人烧伤创面的大小。
