Experience of computer aided burn size determination in pediatric and adult patients

Experience of computer aided burn size determination in pediatric and adult patients M. Giretzlehner1, S. Thumfart1, C. Thumfart2, R. Lingitz3, K. Pfurtscheller3, H.L. Haller4, L.P. Kamolz5 1) RISC Software GmbH, Johannes Kepler University Linz, Hagenberg, Austria 2) Paracelsus Medical University, Salzburg, Austria 3) Pediatric Intensive Care Unit, Department for Pediatrics, Medical University Graz, Graz, Austria 4) UKH Linz der AUVA, HLMedConsult, Austria 5) Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, Graz, Austria Objectives The total burned body surface area (TBBSA) is one of the most important facts for the treatment of burn victims. In daily routine, the TBBSA is often over- or underestimated which could lead to severe problems. The determination of the burned TBSA is done by different methods (Hand-Rule, Rule-of-Nines, Lund-Browder Chart, 2D/3D computer aided methods), but not all are applicable in pediatric patients. Methods We have performed multiple investigations and studies to analyze the difference between conventional assessments and computer-aided approaches. Methods used reached from retrospective analysis of medical records with computer-aided re-assessment to study set-ups using photos with highlighted borders or mannequins with artificial wounds. If needed, we used 2D and 3D scans to obtain a gold standard. Raters used different methods and levels of experience in TBBSA-Determination have been included. We performed statistical analysis, inter rater error determination and analysis of deviations of conventional to computer-aided methods. Results The analysis of multiple investigations sums up the experience of computer-aided burn size determination in pediatric and adult patients during the last years. The usage of existing conventional methods has shown significant deviations, even among experts. In comparison to computer-aided methods, we detected over-assessments of TBBSA of up to 161%. On the other hand, even unexperienced raters can reach very good agreement with the gold standard by using computer-aided methods. At high-qualified burn experts, the usage of computer-aided methods showed a significant improvement of the Inter-Rater-Reliability. Conclusion/Discussion In order to overcome errors and variations in TBBSA assessment and to generate comparable diagnoses, the usage of objective computer-aided methods is highly recommended. The usage of computer-aided methods for TBBSA determination has the ability to accelerate the learning curve of this important medical assessment. Proportionally correct models for infants, children, adolescents and adults are available and new approaches of web-based TBBSA assessment tools are upcoming and promising. External Funding The presented research was funded by the Upper Austrian Government.