Lund-Browder Chart: Age-adjusted TBSA estimation for burn management.
TBSA Estimator
Select the patient age group and tap the affected body regions to estimate the total body surface area burned.
Guidelines & Evidence
Verified
Last Review: 2026-07-17
When to Use
When to Use
Accurate estimation of Total Body Surface Area (TBSA) affected by partial- and full-thickness burns.
Particularly critical in pediatric burn assessment, where body proportions differ significantly from adults (e.g., larger head-to-body ratio).
Guiding fluid resuscitation calculations (e.g., Parkland formula).
Determining transfer eligibility to a specialized burn center.
When NOT to Use
Do NOT include superficial (first-degree) burns (e.g., simple sunburn) in the TBSA calculation.
For very small, scattered burns, the palmar method (patient's palm = 1% TBSA) is often faster and sufficiently accurate.
How it Works
Proportional Adjustments by Age
Unlike the "Rule of Nines," the Lund-Browder chart compensates for the variation in body shape with age. The percentage of TBSA allocated to the head decreases with age, while the percentage allocated to the legs increases.
Key Body Area Percentages (Adult vs. Infant 0-1 yr)
Head: Adult (7%), Infant (19%)
Thigh (each): Adult (9.5%), Infant (5.5%)
Leg (each): Adult (7%), Infant (5%)
Neck: 2% (Constant)
Trunk (front/back each): 13% (Constant)
Arm (each): 4% (Constant)
Forearm (each): 3% (Constant)
Hand (each): 2.5% (Constant)
Foot (each): 3.5% (Constant)
Genitals: 1% (Constant)
Clinical Pearls
Clinical Pearls
The Lund-Browder chart is the most accurate method for determining burn TBSA, especially in children, reducing the risk of over- or under-resuscitation.
Erythema (first-degree burn) must be strictly excluded. Only second-degree (blistering/partial thickness) and third-degree (full thickness) burns are counted.
Overestimating burn size is a common error; using the Lund-Browder diagram systematically helps prevent compounding errors.
Next Steps
Resuscitation & Triage
01
Use the calculated TBSA to drive fluid resuscitation protocols (e.g., Parkland formula: 4 mL × kg × %TBSA).
02
Consider Burn Center Referral if: Partial thickness burns > 10% TBSA, any third-degree burns, burns involving face/hands/feet/genitalia/major joints, electrical or chemical burns, or inhalation injury.
The Evidence
Primary Reference
The estimation of areas of burns.
Lund CC et al. • Surg Gynecol Obstet.. 1944;79:352-358. The original derivation of the chart mapping proportional body surface area changes from infancy to adulthood.
Origins & History
Developed in 1944 by Dr. Charles C. Lund and Dr. Newton C. Browder, surgeons in Boston. They recognized that the "Rule of Nines" was dangerously inaccurate for pediatric patients due to the child's disproportionately large head and smaller extremities. Their chart remains the international standard for burn assessment in children.
Last Comprehensive Review: 2026-07-17