Determination of hand and palm area as a ratio of body surface area in Indian population

Background: Accurate estimation of body surface area (BSA) burn is important. In small and patchy burns, the patient's hand is used to estimate percentage of burn which is traditionally considered as 1%. There is discrepancy about what percentage of TBSA is constituted by the palm and hand. Therefore, this study was designed to determine correctly the TBSA represented by the palmar surface of the entire hand and palm in the Indian population. Material and Methods: 300 healthy adult (male and female) and 300 healthy children (male and female) were included in the study. TBSA was calculated using DuBois formula and hand and palm surface area was calculated using hand tracing on plain paper. The hand/palm percentage of BSA (ratio) was determined by dividing hand/palm surface area by total BSA. Results: The mean hand and palm ratio for adults was 0.92% and 0.50%, respectively. The mean hand and palm ratio in children was 1.06% and 0.632%, respectively. Conclusion: The hand area (palm plus digits) is more closely represented to 1% of TBSA in Indian population.