S. D. Wohlgemuth and D. B. Stefan, "Does the 'Rule of Nines' Apply to Morbidly Obese Burn Victims? A Post-Bariatric Surgery Longitudinal Follow-up to the Original Patient Data Set", in Proc. of 4th Int. Conf. on 3D Body Scanning Technologies, Long Beach CA, USA, 2013, pp. 92-97, http://dx.doi.org/10.15221/13.092.
Does the "Rule of Nines" Apply to Morbidly Obese Burn Victims? A Post-Bariatric Surgery Longitudinal Follow-up to the Original Patient Data Set
Stephen D. WOHLGEMUTH 1,2, David STEFAN 3
1 Eastern Virginia Medical School, Norfolk VA, USA;
2 Sentara Comprehensive Weight Loss Solutions, Norfolk VA, USA;
3 Novaptus Systems Inc. Chesapeake, VA, USA
Background. The Rule of Nines is a method of estimating the extent of body surface that has been burned in an adult, dividing the body into sections or multiples of 9 percent. This assumes a "normal" adult shape. The shape of the bariatric subject is exaggerated. Is the Rule of Nines applicable to the bariatric subject?
Methods. 200 bariatric patients of various shapes and sizes were scanned using a 3D whole body scanning device. The scanner captured an accurate, measurable 3D body model. Software was programmed to determine the surface area of the arms, torso and legs. Height, weight, BMI, gender and body shape were tabulated. A statistical analysis was performed.
Results. The Rule of Nines is a poor approximation and not applicable for the bariatric patient. Average Torso Surface Area was 47% compared to 36% for the "normal" shape. Arms Surface Area was 7% compared to 9%. Legs Surface Area was 15% compared to 18%. Android shapes had an Average Torso Surface Area of 49%. Gynecoid shapes had an Average Torso Surface of 43% Analysis was further divided by gender.
Conclusion. It appears a "Rule of Sevens" is a more appropriate method for estimating the extent of body surface for the bariatric subject, a significant 27% difference from the Rule of Nines. BMI, height and weight appear to have little influence on this relationship. This "Rule of Sevens" can be a useful discovery to assist treating severely burned bariatric adults.
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