Determination of Hand Surface Area as a Percentage of Body Surface Area: A Preliminary Cadaveric Study

Introduction: Estimating body surface area (BSA) is vital in several clinical fields. Routinely height and weight are used to calculate BSA. Due to practical limitations, alternative methods like hand surface area (HSA) are used to estimate BSA. In clinical practice, it is assumed that HSA is equal to 1% BSA. Ethnicity, age and sex are factors that can influence percentage HSA. 
Methods: We used 65 formalin-fixed cadavers (n = 65; 34 males and 31 females; ages 58–76) provided to the Department of Anatomy, University of Ruhuna, Sri Lanka for this study. Standard anthropometric techniques were used to record the height and weight of the cadaver. A digital sliding caliper that could measure to the closest 0.01mm was used to measure the length and width of the hands. The DuBois-DuBois formula was used to calculate BSA, and %HSA (HSA/BSA × 100%) was computed. 
Results: Mean ages of the study subjects (male: 70.66 ± 5.09 years; female: 69.49 ± 7.69years) were not significantly different between the genders. Mean weight (male: 63.26±12.59kg; female: 50.42±11.46 kg) and height (male: 167.23±6.91cm; female: 1age.61±6.20cm), hand length (male: female: ), hand width (male: female: ), HSA (male: female: ), BSA was found to higher in males, compared to females and was statistically significant (P < 0.01). The %HSA was 0.87% for males and 0.85% for females. 
Conclusion: The findings reinforce ethnic and gender variations observed in %HSA, providing reference data pertaining %HSA for an adult Sri Lankan population, thus emphasizing the necessity for population-specific values to minimize potential errors in assuming 1% rule for HSA.