According to “rule of nines”, burns involving perineum are:
High-Yield Explanation
Burn Size (% BSA)
Determination of burn size estimates the extent of injury.
Burn size is assessed by Wallace rule of nines (By Alfred Russel Wallace)
Wallace Rule of Nines:
In adults:
- Each upper extremity: 9%
- Head and neck: 9%
- Lower extremities: 18%
- Anterior and posterior aspects of the trunk: 18%
- Perineum and genitalia: 1%
Children have a relatively larger proportion of body surface area in their head and neck, which is compensated by a relatively smaller surface area in the lower extremities.
- In infants: Head and neck- 21%; Each leg-13%
Berkow formula is used to accurately determine burn size in children.
For estimating smaller burns: Area of open hand (including palm and extended fingers) of the patient is approximately 1% of TBSA.
This method is helpful in evaluating splash burns and burns of mixed distribution.