A comparison study of methods for estimation of a burn surface area: Lund and Browder, e-burn and Mersey Burns.

Introduction: One of the greatest challenges in burn care is the estimation of a total burn surface area (TBSA). It is especially challenging and needs to take into account the growing proportions and the age of a paediatric patient. The aims of this study is to: (1) assess the reliability of the three modalities (LB, MB, and EB) in calculating the extent of burn injuries and fluid resuscitation, and (2) compare the features in terms of usability and efficacy.

Methods: Participants were recruited from Women's and Children's Hospital (WCH), South Australia's surgical and emergency department. Participants were introduced to LB, MB and EB, and then commenced calculation of TBSA on two simulated paediatric (patient A: 12 months, patient B: 4 years) burns. The participants were categorized into three groups; (1) Burns-naïve, (2) Burns-experienced, and (3) Burns-expert.

Results: A total of 45 participants took part in this validation study: doctors (49%), nurses (33%), nursing students (11%) and medical students (7%). The burns-naïve group demonstrated higher means in both patients and has greater variance, TBSA mean 28.8%, range 14-40.5% and mean 37.4%, range 20-52.3% in patient A and B respectively. Two-way ANOVA analysis shows a statistically significant interaction between the effects of level of experience and use of applications on estimation of TBSA in larger burns.

Conclusion: Innovative software and mobile applications demonstrate a high potential as clinical adjuncts in achieving better health outcomes in any health care system. Both Mersey Burns and e-burn reduced the risk of human error particularly from untrained or non-specialised clinicians, however, e-burn proved to be more favourable in our study. Technology-aided models are the future of burns assessment, and further studies are warranted to determine their impact on overall clinical outcome.