Influencing factors for use of the Lund and Browder Chart for TBSA estimation in Western Australia

Isha Bagwe1, Lisa J Martin2, Fiona M Wood3

1 University of Western Australia, 35 Stirling Hwy, Crawley, WA, 6009,

2 Director of the Burn Service of WA, Perth Children’s Hospital, 15 Hospital Ave, Nedlands WA 6009

3 Royal College of Surgeons in Ireland, Dublin, Ireland


Burn injuries in children are an important cause of morbidity and mortality. Accurate assessment of burn size as a percentage of total body surface area (TBSA) is important as it determines the need for fluid resuscitation or transfer to specialized burn unit and is a measure of patient prognosis. The Lund and Browder chart (LBC) is the most accurate tool to measure TBSA in paediatric burn injuries. The aim of the study was to identify the factors that influence LBC use to estimate TBSA in paediatric burn care in Western Australia.

An audit of patient data submitted to the Burns Registry of Australia and New Zealand (BRANZ) from the paediatric burns unit in Perth, Western Australia, from 2016 to 2018, was conducted. Multivariate logistic regression analysis, t-tests and chi2 tests were used to to assess the influencing factors on LB completion.

LBC was used to calculate TBSA in approximately one-third of the paediatric patients and was appropriately dependent on burn size (p=0.002) and time from injury to admission (p=0.007). The involvement of multiple sites was an important clinical factor that influenced LBC use (p=0.065). Education programs that focus on the importance of LBC use and correct charting technique could help increase LB use in this environment.


Lisa is a research fellow who has worked in burns research for the past ten years. Her nursing background was in critical care, followed by clinical trials and research nursing in general medicine and cardiology. She has recently completed a PhD in psychological recovery after adult burn and currently has secured funding for post doctoral work to continue her work in this area.  She has a strong interest in burn prevention and is an active member od the ANZBA prevention committee.

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