Burn Surface Area Estimation in Children

The accurate estimation of burn surface area is crucial for determining treatment, especially fluid resuscitation needs.

Pediatric Burn Assessment Method

For children under 15 years of age, the Lund and Browder chart is the preferred method for estimating the percentage of total body surface area (TBSA) affected by burns. This chart accounts for the changing body proportions of children as they grow, specifically the larger relative size of the head and smaller relative size of the legs in younger children, compared to adults.

Alternative Methods and Their Limitations

• Rule of Nines: This method divides the adult body into regions representing 9% TBSA. It is less accurate for children because their body proportions differ significantly from adults.
• Berkow body surface area chart: While a chart exists, the Lund and Browder chart offers greater detail and accuracy for pediatric patients.
• Parkland formula: This is a formula used for calculating the volume of intravenous fluids required for burn victims in the first 24 hours post-injury (e.g., 4 mL x body weight in kg x % TBSA burned). It does not estimate the burn surface area itself.

Therefore, the Lund and Browder chart provides the most precise estimation for burn injuries in the pediatric population.