The index of deep burn injury: an analysis of 66 extremity sites in 15 children.

The group of burn injuries generally classified as 'fourth degree' vary enormously in extent and severity. This fact, and the absence of a widely accepted grading system for these relatively uncommon injuries, has hindered our ability to learn from the experiences of others as reported in the literature. Based on a series of cadaver dissections, the Index of Deep Burn Injury (IDBI) was developed to provide such a classification scheme. The initial experience with the IDBI in a group of locally destructive "fourth degree' wounds is presented. It is believed that this index has the potential to improve our ability to describe highly destructive wounds.