Publication: Estimation of total body surface area burned - A comparison between burn unit and referring facilities
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Date
2022
Authors
Lian, Ho Hui
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Abstract
Background: Accuracy of burn size estimation is critical in acute burn management which directly affects the patient’s outcome and prognosis. This study aims to quantify the discrepancies of TBSA (Total Body Surface Area) calculated by the Burn Unit staffs (TBSAb) and the personnel from the referring facilities (TBSAr). Methods. A retrospective review of all referred adult and pediatric patients admitted to the Hospital USM (Universiti Sains Malaysia) Burn Unit within 24 hours post burn was performed from year 2015 to 2019. Percentage TBSA discrepancies were calculated the difference between TBSAb and TBSAr. Results: A total of 208 patients (111 adults and 97 pediatrics) were recruited in this study. Of these, the measurements were 60.58% overestimated, 13.46% underestimated, 7.69% accurate. A total of 18.27% of the referrals had no TBSAr stated. The %TBSA discrepancy was the highest in severe burns with mean difference of 10.80 in adults and 7.59 in paediatrics (P<0.001). Time interval between referral and reassessment and patients’ BMI were not statistically significant for magnitude of TBSA discrepancies. Number of burn areas involved correlated with the %TBSA discrepancies with the highest recorded discrepancy being 21.50 in whole body involvement. Conclusion: There was significant discrepancies of TBSA estimation between the referring facilities and that of the Hospital USM Burn Unit. Implementation of educational programs by the burn care experts and agreement of a universal method of TBSA assessment are deemed necessary in reducing the discrepancies. Accurate TBSA estimation serves as an important course for the development of a universal tool for fast and accurate TBSA estimation even in the hands of inexperienced medical staffs
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Keywords
Total Burn Surface Area (TBSA) , Discrepancy