Report by: Saiqa Hussain, Medical Student

Search checked by: Craig Ferguson, SpR Emergency Medicine

Institution: Manchester Royal Infirmary, Manchester, UK

A short-cut review was carried out to establish whether there is one assessment method that is the most accurate at estimating the surface area of a burn. Over 1500 papers were found using the reported searches, of which five presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are shown in table 1. It is concluded that there is no evidence to show benefit of one form of estimation over another in clinical practice.

CLINICAL SCENARIO

A 30-year-old woman is brought to the emergency department with extensive burns after having been trapped in a burning car. After initial resuscitation of the patient you attempt to assess the surface area of skin affected by the burn in order to guide the volume of fluid required for resuscitation. You wonder which method of surface area assessment is the best tool for assessing the surface area of her burns.

THREE-PART QUESTION

In a [patient with a burn] is there one [method of assessment of size] that is most [accurate to assess surface area of the wound]?

SEARCH STRATEGY

Medline using the OVID interface 1966 to May 2009:[burn$.mp OR exp Burns OR heat injur$.mp OR thermal injur$.mp OR scald.mp] AND [assess$.mp …