Burn Area (Rule of Nines / Lund–Browder)

Lund CC, Browder NC. The estimation of areas of burns. Surgery, Gynecology & Obstetrics 1944;79:352–8 (no PubMed record). Age-adjusted chart: head, thighs and lower legs change with age; burns are drawn on the chart and simple erythema is ignored.

Holm S, Engström O, Petäjä I, Huss F. Does the estimation of burn extent at admission differ from the assessment at discharge? Table 1 gives the rule of nines (adapted from Knaysi et al.): head and neck 9, each arm 9, each leg 18, anterior trunk 18, posterior trunk 18, genitalia 1 %; children have a proportionally larger head and smaller legs, so an age-appropriate chart is needed.

Miminas DA. A critical evaluation of the Lund and Browder chart. Wounds UK 2007;3(3):58–68 — reproduces the chart with the age table used here (A ½ head, B ½ thigh, C ½ lower leg at 0, 1, 5, 10, 15 years and adult). Giretzlehner M et al., Medicina 2021 (PMID 33807630): first-degree burns are excluded from the burned area, and burn size is often overestimated. Rule of nines: Wallace AB, Lancet 1951 (PMID 14805109).