Efficacy of burned surface area estimates calculated from charts--the need for a computer-based model.

An accurate estimation of burn surface area is needed to correctly calculate initial fluid resuscitation, nutritional requirements, prognosis, and comparisons of treatment protocols among burn centers. The following experiment was conducted to test the accuracy of physicians compared to a computer-assisted method. Twenty-seven physicians were asked to estimate the per cent of burned surface area from an adult patient diagram. Physicians were found to consistently overestimate the percentage of burned surface area. The average physician estimate was 42% compared to 29.6% calculated by a computer-assisted program. The degree of error between physician estimates and actual TBSA burned is significant and may critically affect patient management. Additional benefits of computer assistance include a permanent record of injury, burn wound trend analysis, and meaningful statistics involving morbidity, mortality, and comparative treatment protocols among burn centers.