The Lund method, more accurately known as the Lund and Browder chart, is a tool for estimating the total body surface area (TBSA) affected by burns.
Understanding the Lund and Browder Chart
Purpose of the Chart
The primary purpose of the Lund and Browder chart is to provide a more accurate estimate of the percentage of the body surface area that has been burned. This is crucial for fluid resuscitation, medication dosing, and overall burn management.
Key Features of the Chart
- Age-Specific Adjustments: Unlike the "rule of nines," which is often used for adults, the Lund and Browder chart takes into account the varying body surface area proportions in children. The head and legs make up a larger percentage of TBSA in infants and children than in adults.
- Detailed Body Part Breakdown: The chart divides the body into specific regions, each with a unique percentage of the total body surface area.
Development of the Chart
- Created by: The Lund and Browder chart was developed by Dr. Charles Lund, Senior Surgeon at Boston City Hospital, and Dr. Browder.
- Context: Their intention was to create a tool that was more specific and precise for use in clinical settings.
How to Use the Chart
- Identify the Burned Areas: Carefully assess the patient to determine the extent of the burn injury.
- Use the Chart: Match the burned regions to the corresponding body parts on the Lund and Browder chart.
- Calculate the TBSA: Add up the percentages for each affected region.
- Consider Age: Take into account the age-adjusted percentages.
Advantages of the Lund and Browder Chart
- More Accurate in Children: It provides far more accurate estimates for children than the rule of nines.
- Precision: It offers better precision due to detailed breakdown of the body.
- Improved Treatment: The accurate calculation of the burn area leads to more effective treatment, especially in regards to fluid resuscitation.
Example:
| Body Part | TBSA % (Adult) | TBSA % (Infant) |
|---|---|---|
| Head | 9 | 18 |
| Anterior Trunk | 18 | 18 |
| Posterior Trunk | 18 | 18 |
| One Entire Arm | 9 | 9 |
| One Entire Leg | 18 | 13.5 |
| Perineum | 1 | 1 |
Please Note that these figures are approximate, and the Lund and Browder chart provides more precise proportions for different age groups.
Importance in Burn Management
- Fluid Resuscitation: Precise TBSA estimation is critical in calculating the amount of intravenous fluids needed to prevent shock.
- Medication Dosage: Accurate body surface area calculation aids in the correct dosing of medications.
- Prognosis and Planning: Estimating the burn size is an important component in determining the severity of the burn and the need for specialized care.
