Plastic Surgery

Burn severity assessment with Rule of Nines

Burn severity assessment begins with accurate total body surface area (TBSA) calculation using the Rule of Nines for adults and the Lund-Browder chart for children, which accounts for developmental changes in body proportions. TBSA is the primary determinant of fluid resuscitation volume, transfer to a burn center, and mortality risk.

Fluid resuscitation with Parkland formula

Fluid resuscitation in burn shock follows the Parkland formula (4 mL/kg/%TBSA lactated Ringer's in the first 24 hours), with half of the volume administered in the first 8 hours post-injury and the remainder over the subsequent 16 hours. The modified Brooke formula (2 mL/kg/%TBSA) provides an alternative approach aimed at reducing fluid overload and abdominal compartment syndrome.

Burn mortality prediction with Baux and ABSI

The revised Baux score (age + %TBSA + 17 [if inhalation injury]) predicts burn mortality and guides triage decisions including palliative care consideration in patients with predicted mortality exceeding 90%. The ABSI (Abbreviated Burn Severity Index) provides an alternative five-variable mortality prediction model.