High-precision computer-assisted surface area estimation in large surface burn patients using ImageJ - A comparative analysis.

[AIMS] Several methods for calculating the extent of large surface burns have been described in the literature. However, the commonly used methods have several limitations and an overall tendency to overestimate the burn area. This study aimed to use ImageJ for high-precision computer-assisted estimation of large surface burns.

[METHODS] A retrospective analysis of the burn registry of the Department of Plastic, Aesthetic, Hand and Reconstructive Surgery of Hannover Medical School was performed from 1st January 2018 to 1st July 2024. Photo documentation of large surface burn patients was used to estimate the total body surface area (TBSA) using ImageJ and compared it to the estimations made by the referring emergency doctor, consultant plastic surgeon and a smartphone application (E-burn 1.0.0).

[RESULTS] A total of 37 patients were included in this study. The mean TBSA evaluated by ImageJ was 36.81 %, which was statistically significantly lower than estimations made by a consultant plastic surgeon with 41 % mean TBSA (p = 0.008) and referring emergency doctors with 50.97 % mean TBSA (p < 0.0001). There was no statistically significant correlation between the estimation made by ImageJ and that made by the smartphone application which estimated a mean TBSA of 37.84 % (p = 0.1225).

[CONCLUSIONS] ImageJ may be used for high-precision computer-assisted volume estimation of large surface burns by counting pixel by pixel to provide highly accurate TBSA estimations.