Human model of burn injury that quantifies the benefit of cooling as a first aid measure

Abstract

Background: Burn injuries are a major cause of morbidity and mortality worldwide. Cooling is widely practised as a first aid measure, but the efficacy of cooling burns in human skin has not been demonstrated. A safe, consistent, ethically acceptable model of burning and cooling in live human skin in vivo was developed, and used to quantify the effects of cooling.Methods: Novel apparatus was manufactured to create and cool burns in women who were anaesthetized for breast reconstruction surgery using a deep inferior epigastric artery perforator flap. Burns were excised between 1 and 3 h after creation, and analysed using histopathological assessment.Results: All 25 women who were approached agreed to take part in the study. There were no adverse events. Increased duration of contact led to increased burn depth, with a contact time of 7⋅5 s at 70 ∘ C leading to a mid-dermal burn. Burn depth progressed over time following injury, but importantly this was modified by cooling the burn at 16 ∘ C for 20 min. On average, cooling salvaged 25⋅2 per cent of the dermal thickness.Conclusion: This study demonstrated the favourable effects of cooling on human burns. Public heath messaging should emphasize cooling as first aid for burns. This model will allow analysis of the molecular effects of cooling burns, and provide a platform for testing novel therapies aimed at reducing the impact of burn injury.

Hydrogels in Burn Wound Management—A Review

“…However, it can also have an anti-inflammatory effect [ 12 ]. In the experimental models, it was proved that cooling a burn at 16 °C for 20 min was the most favorable within first hour after the burn [ 13 , 14 ]. Most burn associations recommend burn wound cooling with tap water, however, there are some concerns regarding the time of cooling.…”

3D printing programmable liquid crystal elastomer soft pneumatic actuators

“…40 However, when actuated by heat, LCEs typically need to be heated to several tens of degrees Celsius, 55 which is considerably higher than the safe temperature of most biological systems. 56,57 Additionally, traditional LCE materials maintain their actuated state, requiring continuous input of external stimuli. Consequently, large amounts of energy would be wasted owing to heat dissipation.…”

European Resuscitation Council Guidelines 2021: First aid

“…221 One human model study has subsequently shown that cooling burns at 16 C for 20 min favourably modified the injury. 222 The ILCOR Task Force, when discussing its 2019 Scoping Review of the management of burns, 4,5 made an additional recommendation as a good practice point to actively cool burns by cool or cold (but not freezing) water for at least 20 min. The ERC guideline has therefore been updated to lengthen the recommended cooling time for burns to at least 20 min.…”