BurnCalc assessment study of computer-aided individual three-dimensional burn area calculation

BackgroundAccurate estimation of a burned area is crucial to decisions about fluid resuscitation, surgical options, nutritional support, and prognosis. Widely used clinical methods to estimate a burn area are two-dimensional. They do not consider age, sex, body mass, physical deformities, or other relevant factors. Computer-aided methods have improved the accuracy of estimating burned areas by including data analysis and reducing subjective differences. Three-dimensional (3D) scanning allows us to determine body dimensions rapidly and reproducibly. We describe an individualized, cost-efficient, portable 3D scanning system, BurnCalc, that can create an individual 3D model and then calculate body surface area (BSA) and the burn area accurately and quickly.MethodsThe BurnCalc system was validated by verifying the accuracy and stability of BSA calculation. We measured 10 regular objects in experiment 1, using Student’s t-test and the intraclass correlation coefficient (ICC) in the analysis. In experiment 2, artificial paper patches of known dimensions were attached to various parts of the body of 40 volunteers. Their sizes were then calculated using BurnCalc. The BurnCalc data were compared to actually measured values to verify accuracy and stability. Total BSAs of these 40 volunteers were also calculated by BurnCalc and compared to those derived from an accepted formula. In experiment 3, four experts using Chinese Rule-of-Nines or Rule-of-Palms methods calculated the percentages of the total BSA in 17 volunteers. Student’s t-test and ICC, respectively, were used to compare the results obtained with the BurnCalc technique.ResultsStatistically, in experiment 1, p = 0.834 and ICC = 0.999, demonstrating that there was no difference between the BurnCalc and real measurements. Also, the hypothesis of null difference among measures (experiment 2) was true because p > 0.05 and ICC = 0.999, indicating that calculations of the total BSA and the burn area were more accurate using the BurnCalc technology. The reliability of the BurnCalc program was 99.9%. In experiment 3, only the BurnCalc method exhibited values of p > 0.05 (p = 0.774) and ICC = 0.999.ConclusionsBurnCalc technology produced stable, accurate readings, suggesting that BurnCalc could be regarded as a new standard clinical method.

[1]  J. Dirnberger,et al.  Comments on "a system for 3D representation of burns and calculation of burnt skin area". , 2012, Burns : journal of the International Society for Burn Injuries.

[2]  Andrew W. Fitzgibbon,et al.  KinectFusion: real-time 3D reconstruction and interaction using a moving depth camera , 2011, UIST.

[3]  K. Dunn,et al.  Estimation of breast burn size. , 2005, Plastic and reconstructive surgery.

[4]  Wilfried De Backer,et al.  Body surface area in normal-weight, overweight, and obese adults. A comparison study. , 2006, Metabolism: clinical and experimental.

[5]  N. Rossiter,et al.  How big is a hand? , 1996, Burns : journal of the International Society for Burn Injuries.

[6]  J. Alexander,et al.  Estimation of body surface area of extremely obese human subjects. , 1960, Journal of applied physiology.

[7]  Pierre Hellier,et al.  Level Set Methods in an EM Framework for Shape Classification and Estimation , 2004, International Conference on Medical Image Computing and Computer-Assisted Intervention.

[8]  Paul J. Besl,et al.  A Method for Registration of 3-D Shapes , 1992, IEEE Trans. Pattern Anal. Mach. Intell..

[9]  Chih-Yong Chen,et al.  Determination of hand surface area as a percentage of body surface area by 3D anthropometry. , 2008, Burns : journal of the International Society for Burn Injuries.

[10]  E. Livingston,et al.  Percentage of burned body surface area determination in obese and nonobese patients. , 2000, The Journal of surgical research.

[11]  Johannes Dirnberger,et al.  BurnCase 3D - Realistic Adaptation of 3-Dimensional Human Body Models , 2004, MICCAI.

[12]  Jeong-Wha Choi,et al.  Determination of body surface area and formulas to estimate body surface area using the alginate method. , 2008, Journal of physiological anthropology.

[13]  D. Orgill,et al.  A review of computer-aided body surface area determination: SAGE II and EPRI's 3D Burn Vision. , 2002, The Journal of burn care & rehabilitation.

[14]  C. Berry,et al.  The inter-rater reliability of estimating the size of burns from various burn area chart drawings. , 2000, Burns : journal of the International Society for Burn Injuries.

[15]  Gang Tao,et al.  A Comparison Study , 2003 .

[16]  Dietmar Stöckl,et al.  Application of the Bland-Altman plot for interpretation of method-comparison studies: a critical investigation of its practice. , 2002, Clinical chemistry.

[17]  Wen-Ko Chiou,et al.  The 3D scanner for measuring body surface area: a simplified calculation in the Chinese adult. , 2003, Applied ergonomics.

[18]  C. Serrano,et al.  A system for 3D representation of burns and calculation of burnt skin area. , 2011, Burns : journal of the International Society for Burn Injuries.

[19]  H R Amirsheybani,et al.  The Natural History of the Growth of the Hand: I. Hand Area as a Percentage of Body Surface Area , 2001, Plastic and reconstructive surgery.

[20]  E. Gehan,et al.  Estimation of human body surface area from height and weight. , 1970, Cancer chemotherapy reports.

[21]  R. Edlich,et al.  Efficacy of burned surface area estimates calculated from charts--the need for a computer-based model. , 1985, The Journal of trauma.

[22]  Scott R. Klemmer,et al.  Proceedings of the 24th annual ACM symposium adjunct on User interface software and technology , 2011, UIST 2011.

[23]  J. Dirnberger,et al.  "Understanding burns": research project BurnCase 3D--overcome the limits of existing methods in burns documentation. , 2009, Burns : journal of the International Society for Burn Injuries.

[24]  J. Crawford,et al.  Simplification of drug dosage calculation by application of the surface area principle. , 1950, Pediatrics.

[25]  Binns Ch,et al.  Hydrogen-sulphide poisoning. , 1978 .

[26]  J. Dirnberger,et al.  Modelling human burn injuries in a three-dimensional virtual environment. , 2003, Studies in health technology and informatics.

[27]  J A Mattar,et al.  A simple calculation to estimate body surface area in adults and its correlation with the Du Bois formula. , 1989, Critical care medicine.

[28]  Pierre Graebling,et al.  Robust Structured Light Coding for 3D Reconstruction , 2007, 2007 IEEE 11th International Conference on Computer Vision.

[29]  C. S. Davidson,et al.  PROBLEMS OF PROTEIN NUTRITION IN BURNED PATIENTS. , 1943, Annals of surgery.

[30]  A B WALLACE,et al.  The exposure treatment of burns. , 1951, Lancet.

[31]  P. Treleaven,et al.  Whole-body three-dimensional photonic scanning: a new technique for obesity research and clinical practice , 2008, International Journal of Obesity.

[32]  Rajive Mathew Jose,et al.  Burns area estimation-an error perpetuated. , 2004, Burns : journal of the International Society for Burn Injuries.