Total body surface area

Total Body Surface Area (TBSA) is a measure of the percentage of the body covered by burns, used in the medical management of burn victims. TBSA is an important aspect of burn assessment and is used to guide treatment decisions including fluid resuscitation and becomes a critical determinant of burn shock.

Calculation

The calculation of TBSA utilizes various formulas, with the most common being the Rule of Nines. This method divides the body into sections of 9% (or multiples thereof), with the palm of the hand approximating to 1% of the body's surface area. Other methods include the Lund and Browder chart which provides more accuracy by considering variations in body shape with age and the Parkland formula for estimating fluid requirements.

Clinical Significance

The TBSA is crucial in the prognosis of burn patients. Burns involving more than 30% of the TBSA are associated with significant morbidity and mortality. It is also used to determine the need for burn unit admission and to calculate fluid requirements for resuscitation in the acute phase post-burn.

See Also

• Burn
• Rule of Nines
• Lund and Browder chart
• Parkland formula
• Burn center
• Acute phase reaction