Trends in Paediatric Burn Size Estimation

Roland Deek¹, Linda Quinn¹, Bernard Carney¹, Michelle Lodge¹, Darren Molony¹, Amy Jeeves¹,
¹Women’s And Children’s Hospital, Adelaide, South Australia, Australia

Abstract

Background:
Accurate calculation of burn size is critical for burn care. Research suggests that burn size calculations by referring clinicians tend to be inaccurate. This may impact early burn management and fluid resuscitation, thus leading to worse outcomes. The aim of this study was to determine the accuracy of TBSA burn estimations for rural patients referred to the Women’s and Children’s Hospital (WCH) Burn Unit. A secondary aim was to identify if trends in burn size estimation have improved over time.

Methodology:
Retrospective review of all burn-injured paediatric patients with >15% TBSA referred to the WCH Burn Unit between 2013-2023. Referral TBSA calculations were compared with calculations by the Burn Unit. These findings were then compared to historical data from 2002-2008.

Results:
A total of 19 patients were identified (mean age 4.7 years), with Aboriginal children accounting for 63% of cases (n=12). Most major burns occurred at home (n=14), and were either scald (n=12) or flame (n=7) burns. Mean TBSA burned was 28.7% (range 15-67, SD 18.4). Mean length of stay was 47.5 days (range 3-207, SD 61.1). Burn size overestimation by referring centres occurred in 8 cases (44.4%) and underestimation in 4 cases (22.2%). In these cases, the mean absolute difference in TBSA was 12.3%.

Conclusion:
Burn size estimations by referring clinicians remain inaccurate, which is consistent with historical data from the same population. Strategies to improve burn size estimation should focus on improved communication with referring clinicians, additional burns education, and greater utilisation of technology to facilitate burn size estimation.

Biography

Dr Roland Deek is the Plastic Surgery and Burns Resident at the Women’s and Children’s Hospital in Adelaide. He is currently completing a Master of Surgery (with thesis) through the University of Sydney, and is working towards a career in Plastic, Reconstructive and Burns surgery.