“3D Burn Resuscitation: Free Smartphone Application” Utilizing modern technology to effectively manage burn injury by Operation Smile Thailand

The realization of the urgency in treating patients with burn injuries, about 10,000 cases in Thailand alone, has brought Operation Smile Foundation and Chonburi Hospital to fund and work in partnership with multiple parties on the “3D Burn Resuscitation: Free Smartphone Application” which is available to download worldwide at no cost.

An accurate estimation of total body surface area burned is a vital aspect of acute burn management. The 3D Burn Application, available for both adult and pediatric patients, accurately estimates the surface area involved, allowing appropriate calculations for fluid resuscitation and nutritional management to take place. Previous methods used have often been shown to have large discrepancies regarding the percentage of surface area involved; this is likely attributed to the fact that previous methods utilize two dimensions only, and do not allow for several variables that can affect calculations. These issues have been identified as short falls of the Lund & Browder charts which have been used extensively across the globe to assess burns. 3D Burn allows for variables including body type and shape, gender, height, weight and BMI. The three dimensions coupled with the incorporation of extra variables allows this unique application to provide a more accurate measurement when compared to previous methods.

The application is free to use and can be downloaded on all smartphones, android and IOS compatible devices. It provides a technological platform for these calculations as opposed to hand-written formats previously used. The application requires no special equipment, has an easy to use layout, and has proven to be fast, accurate and reliable.

Development of the application started in 2011, with initial versions available for use in 2016. Six different participants (three male and three female) were originally utilized to derive the separate standardized 3D diagrams of total body figures used in the application. The original co-development project took place between staff of the Plastic & Reconstructive Surgical Unit at Chonburi Hospital and the Faculty of Engineering at Kasetsart University. The Thai National Electronic and Computer Technology Center (NECTEC) kindly assisted with visual computerized designs. The mobile application was then developed with collaboration from multiple institutions: Chulalongkorn University, Chonburi Hospital, the Ministry of Public Health of Thailand, Kasetsart University, NECTEC and Operation Smile Foundation.

With a user-friendly visual display, second and third degree burn injuries are differentiated from each other. Users can also rotate through 360 degrees or zoom in on any particular area of interest. After all, burn injury details have been inserted in the application, a recommended IV fluid resuscitation plan is formulated, utilizing the Parkland-Formula which provides a fluid plan for the first 8 hours and the following 16 hours.

A validation study on the application was carried out and published in the Burns & Trauma Journal in 2018*. Results showed that while the application was slightly more time consuming than previous methods, more accurate measurements resulted.

It is anticipated that the 3D Burn Application will revolutionize the way surgical teams assess and manage burn patients, and will one day be incorporated as gold standard practice in burn management worldwide.



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