Giretzlehner Michael, Ganitzer Isabell, Haller Herbert
Research Unit for Medical Informatics, RISC Software GmbH, Johannes Kepler University Linz, Upper Austrian Research GmbH, A-4232 Hagenberg, Austria.
Trauma Hospital Berlin, Trauma Hospital Linz (ret), HLMedConsult, A-4020 Leonding, Austria.
Medicina (Kaunas). 2021 Mar 5;57(3):242. doi: 10.3390/medicina57030242.
In burn medicine, the percentage of the burned body surface area (TBSA-B) to the total body surface area (TBSA) is a crucial parameter to ensure adequate treatment and therapy. Inaccurate estimations of the burn extent can lead to wrong medical decisions resulting in considerable consequences for patients. These include, for instance, over-resuscitation, complications due to fluid aggregation from burn edema, or non-optimal distribution of patients. Due to the frequent inaccurate TBSA-B estimation in practice, objective methods allowing for precise assessments are required. Over time, various methods have been established whose development has been influenced by contemporary technical standards. This article provides an overview of the history of burn size estimation and describes existing methods with a critical view of their benefits and limitations. Traditional methods that are still of great practical relevance were developed from the middle of the 20th century. These include the "Lund Browder Chart", the "Rule of Nines", and the "Rule of Palms". These methods have in common that they assume specific values for different body parts' surface as a proportion of the TBSA. Due to the missing consideration of differences regarding sex, age, weight, height, and body shape, these methods have practical limitations. Due to intensive medical research, it has been possible to develop three-dimensional computer-based systems that consider patients' body characteristics and allow a very realistic burn size assessment. To ensure high-quality burn treatment, comprehensive documentation of the treatment process, and wound healing is essential. Although traditional paper-based documentation is still used in practice, it no longer meets modern requirements. Instead, adequate documentation is ensured by electronic documentation systems. An illustrative software already being used worldwide is "BurnCase 3D". It allows for an accurate burn size assessment and a complete medical documentation.
在烧伤医学中，烧伤体表面积（TBSA - B）占全身表面积（TBSA）的百分比是确保进行充分治疗的关键参数。对烧伤范围的不准确估计可能导致错误的医疗决策，给患者带来严重后果。例如，这些后果包括过度复苏、烧伤水肿导致的液体聚集引起的并发症，或患者分配不合理。由于在实际操作中TBSA - B估计经常不准确，因此需要能够进行精确评估的客观方法。随着时间的推移，已经建立了各种方法，其发展受到当代技术标准的影响。本文概述了烧伤面积估计的历史，并描述了现有方法，同时批判性地审视了它们的优点和局限性。仍具有重要实际意义的传统方法是在20世纪中叶发展起来的。这些方法包括“伦德 - 布劳德图表”、“九分法”和“手掌法”。这些方法的共同之处在于，它们假定不同身体部位的表面积占TBSA的特定值。由于未考虑性别、年龄、体重、身高和体型的差异，这些方法存在实际局限性。由于深入的医学研究，已经能够开发出基于三维计算机的系统，该系统考虑患者的身体特征，并能够进行非常逼真的烧伤面积评估。为确保高质量的烧伤治疗，对治疗过程和伤口愈合进行全面记录至关重要。虽然传统的纸质记录在实践中仍在使用，但它已不再满足现代要求。相反，电子记录系统可确保进行充分的记录。一种已在全球范围内使用的示例性软件是“BurnCase 3D”。它能够进行准确的烧伤面积评估和完整的医疗记录。
