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The Lund and Browder chart is a tool useful in the management of burns for estimating the total body surface area affected. It was created by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Newton Browder, based on their experiences in treating over 300 burn victims injured at the Cocoanut Grove fire in Boston in 1942.
The Wallace rule of nines is a tool used in pre-hospital and emergency medicine to estimate the total body surface area (BSA) affected by a burn.In addition to determining burn severity, the measurement of burn surface area is important for estimating patients' fluid requirements and determining hospital admission criteria.
In adults, the Wallace rule of nines can be used to determine the total percentage of area burned for each major section of the body. [1] In burn cases that involve partial body areas, or when dermatologists are evaluating the Psoriasis Area and Severity Index (PASI) score, the patient's palm can serve a reference point roughly equivalent to 1% ...
Burns that affect only the superficial skin layers are known as superficial or first-degree burns. [2] [11] They appear red without blisters, and pain typically lasts around three days. [2] [11] When the injury extends into some of the underlying skin layer, it is a partial-thickness or second-degree burn. [2]
For example, a person weighing 75 kg with burns to 20% of his or her body surface area would require 4 x 75 x 20 = 6,000 mL of fluid replacement within 24 hours. The first half of this amount is delivered within eight hours from the burn incident, and the remaining fluid is delivered in the next 16 hours.
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The original Baux score was the addition of two factors, the first being the total body surface area affected by burning (usually estimated using the Wallace rule of nines, or calculated using a Lund and Browder chart) and the second being the age of the patient.
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