Accuracy of Currently Used Paper Burn Diagram vs a Three-Dimensional Computerized Model
Accuracy of Currently Used Paper Burn Diagram vs a Three-Dimensional Computerized Model
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DOI：
10.1097/bcr.0000000000000363
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发表时间：
2017-01-01
影响因子：
1.4
通讯作者：
Herndon, David N.
中科院分区：
文献类型：
--
作者：
Benjamin, Nicole C.;Lee, Jong O.;Herndon, David N.
烧伤单位历来使用纸质图表来估计烧伤百分比;然而，可能会发生无意的错误。使用计算机程序，将伤口映射从照片到三维（3D）人体图，可以减少主观准备烧伤图和随后的计算TBSA烧伤。对19名烧伤患者进行了分析，这些患者的估计TBSA烧伤>= 20%。这些患者于2012年7月至2013年9月在德克萨斯州加尔维斯顿的Shriners儿童医院或德克萨斯大学医学分支接受治疗。在患者第一次手术前收集数码照片。使用烧伤绘图软件BurnCase 3D（RISC Software GmbH，Hagenberg，Austria），用户根据照片追踪部分和全层烧伤。然后，该程序将痕迹叠加到3D模型上，并计算燃烧百分比。结果与第一次手术后完成的隆德图和Browder图进行了比较。双尾t检验用于计算统计学差异。对于部分厚度烧伤，使用隆德和Browder图计算的烧伤面积明显大于使用BurnCase 3D计算的烧伤面积（差异15%，P <0.01）。全层烧伤的情况则相反，使用隆德和布劳德图计算时烧伤面积较小（差异11%，P <0.05）。总之，从BurnCase 3D和纸质图表得出的燃烧百分比估计存在实质性差异。在我们的研究队列中，纸图表与高估部分厚度烧伤面积和低估全层烧伤面积有关。需要对BurnCase 3D与其他常用方法进行更多比较研究。
Burn units have historically used paper diagrams to estimate percent burn; however, unintentional errors can occur. The use of a computer program that incorporates wound mapping from photographs onto a three-dimensional (3D) human diagram could decrease subjectivity in preparing burn diagrams and subsequent calculations of TBSA burned. Analyses were done on 19 burned patients who had an estimated TBSA burned of >= 20%. The patients were admitted to Shriners Hospitals for Children or the University of Texas Medical Branch in Galveston, Texas, from July 2012 to September 2013 for treatment. Digital photographs were collected before the patient's first surgery. Using BurnCase 3D (RISC Software GmbH, Hagenberg, Austria), a burn mapping software, the user traced partial-and full-thickness burns from photographs. The program then superimposed tracings onto a 3D model and calculated percent burned. The results were compared with the Lund and Browder diagrams completed after the first operation. A two-tailed t-test was used to calculate statistical differences. For partial-thickness burns, burn sizes calculated using Lund and Browder diagrams were significantly larger than those calculated using BurnCase 3D (15% difference, P < .01). The opposite was found for full-thickness burns, with burn sizes being smaller when calculated using Lund and Browder diagrams (11% difference, P < .05). In conclusion, substantial differences exist in percent burn estimations derived from BurnCase 3D and paper diagrams. In our studied cohort, paper diagrams were associated with overestimation of partial-thickness burn size and underestimation of full-thickness burn size. Additional studies comparing BurnCase 3D with other commonly used methods are warranted.