Department of Dermatology, Royal Perth Hospital, Perth, WA, Australia.
Br J Dermatol. 2013 Jul;169(1):76-84. doi: 10.1111/bjd.12290.
The estimation of body surface area involvement is an important tool. Hand surface area (HSA) or palm surface area (PSA) is commonly used for the estimate, with an assumption that HSA represents 1% of the total body surface area (TBSA).
To establish (i) the most accurate values for mean HSA% and PSA% of TBSA, and (ii) the variability of these with patient variables.
The PubMed, Embase and Cochrane databases were searched and 14 eligible studies were identified. Weighted means of HSA% and PSA% were produced. The meta-analysis examined systematic variation associated with sex, age (for children), body mass index (BMI) and ethnic group using random-effects models.
HSA% is 13% lower than the accepted 1% value for all adults (P = 0.004). PSA% is not significantly different from the accepted 0.5% value (P = 0.82). Men have a significantly higher HSA% than women (P < 0.0001). Children have a significantly higher HSA% than adults (P < 0.0001). HSA% falls with increasing BMI in adults (P < 0.0001). A comparison of European, Chinese and Indian subcontinent ethnic groups showed that each group was different from the others (P < 0.05).
The use of HSA equating to 1% TBSA results in an overestimate for adults (particularly women) and an underestimate for children. PSA equating to 0.5% TBSA appears to be suitable for adults. Patient variables including sex and BMI result in variation of HSA as a percentage of TBSA. The heterogeneity of the included studies and the lack of data for children are the major limitations of this study.
体表面积的评估是一种重要的工具。手表面积（HSA）或手掌表面积（PSA）常用于估计，假设 HSA 占总体表面积（TBSA）的 1%。
建立（i）HSA%和 PSA%与 TBSA 的最准确平均值，以及（ii）这些平均值随患者变量的变化。
在 PubMed、Embase 和 Cochrane 数据库中进行检索，确定了 14 项符合条件的研究。生成 HSA%和 PSA%的加权平均值。使用随机效应模型对性别、年龄（儿童）、体重指数（BMI）和种族组与这些平均值的系统变化进行元分析。
所有成年人的 HSA%比公认的 1%值低 13%（P = 0.004）。PSA%与公认的 0.5%值无显著差异（P = 0.82）。男性的 HSA%显著高于女性（P < 0.0001）。儿童的 HSA%显著高于成年人（P < 0.0001）。成年人的 HSA%随 BMI 的增加而下降（P < 0.0001）。对欧洲、中国和印度次大陆种族群体的比较表明，每个群体都与其他群体不同（P < 0.05）。
使用 HSA 等同于 1% TBSA 会导致成年人（尤其是女性）的高估和儿童的低估。PSA 等同于 0.5% TBSA 似乎适用于成年人。性别和 BMI 等患者变量会导致 HSA 作为 TBSA 的百分比发生变化。本研究的主要局限性是纳入研究的异质性和缺乏儿童数据。
