Burn Classification and Management

Measuring Burn Surface Area

The Lund and Browder Chart is the recommended standardized method for measuring total body surface area (TBSA) for both adults and children, as suggested by the American Society of Anesthesiologists 1, 2
The Rule of Nines is an alternative method, but it is less accurate and not suitable for children, according to the American Burn Association 1
The palm method can also be used, where a patient's palm, including fingers, represents approximately 1% of their TBSA, as recommended by the American College of Surgeons 1

For adults, severe burns are defined as TBSA burned >20% or deep burns >5%, and may also include burns involving face, hands, feet, perineum, or flexure lines, as well as inhalation injury, electrical or chemical burns, and certain comorbidities, according to the American Burn Association 2, 3
For children, severe burns are defined as TBSA >10% or deep burns >5%, and may also include age <1 year, burns involving face, hands, feet, perineum, or flexure lines, circular burns, electrical or chemical burns, and severe comorbidities, as recommended by the American Academy of Pediatrics 1, 2

For superficial burns, cooling with running water for 10-20 minutes, using over-the-counter pain medications, and applying moisturizers or petrolatum-based products are recommended, as suggested by the American Heart Association 4, 3
For partial-thickness burns, cooling with running water for at least 10 minutes, covering with clean, non-adherent dressing, and seeking medical attention if involving critical areas or exceeding 10% TBSA (5% in children) are recommended, according to the American College of Surgeons 4, 3
For full-thickness burns, immediate medical attention is required, and covering with clean, dry, non-adherent dressing while awaiting medical care is recommended, as suggested by the American Burn Association 4, 3

Applying ice directly to burns can cause tissue ischemia, and breaking blisters can increase infection risk, according to the American Heart Association 5, 4
Applying butter, oil, or other home remedies is not recommended, as suggested by the American College of Surgeons 6, 3
Delaying seeking medical attention for burns with blistering or broken skin can lead to complications, according to the American Burn Association 6

Functional limitations can occur with deep burns, as reported by the American Society of Anesthesiologists 2