Venter T H J, Karpelowsky J S, Rode H
Department of Paediatric Surgery, Red Cross Children's Hospital, University of Cape Town, Rondebosch 7700, Cape Town, South Africa.
Burns. 2007 Nov;33(7):917-22. doi: 10.1016/j.burns.2006.10.408. Epub 2007 May 22.
The beneficial effects of cooling a fresh burn wound were well demonstrated. However, there are still conflicting reports as to the optimum temperature of coolant, duration of application and effects in limiting tissue damage. A study was undertaken to investigate this, the importance of the temperature of, and the time period of application of the coolant.
Four identical deep dermal wounds were created on the back of 10 anaesthetised pigs. Each animal served as an independent experimental model. The effectiveness of cooling was monitored by measuring intradermal temperatures. The animals were divided into two groups; using ice water and tap water as the coolants. In each pig one wound was not cooled (wound 1). Three were cooled; one immediately for 30 min in group 1 and for 4 h in group 2 (wound 2). The other two wounds were cooled after 30 min for 30 min and 3 h (wounds 3 and 4, respectively).
It was found that the temperature of the coolant was crucial. When ice water of 1-8 degrees C (group 1) was used more necrosis than in the wounds that were not cooled was seen. When tap water was used at 12-18 degrees C (group 2) it was demonstrated clinically and histologically that the cooled wounds had less necrosis than the uncooled wounds and thus healed faster. In group 2 the beneficial effects of cooling were still present when delayed for half an hour.
First aid cooling of a burn wound with tap water is an effective method of minimising the damage sustained during a burn, and is universally and immediately available. Ice water cooling is associated with an increase in tissue damage.
新鲜烧伤创面冷却的有益效果已得到充分证实。然而，关于冷却剂的最佳温度、应用持续时间以及在限制组织损伤方面的效果，仍存在相互矛盾的报道。为此进行了一项研究，以探讨冷却剂温度和应用时间段的重要性。
在10只麻醉猪的背部制造4个相同的深度真皮伤口。每只动物作为一个独立的实验模型。通过测量皮内温度来监测冷却效果。将动物分为两组；分别使用冰水和自来水作为冷却剂。在每头猪身上，一个伤口不进行冷却（伤口1）。三个伤口进行冷却；在第1组中，一个伤口立即冷却30分钟，在第2组中冷却4小时（伤口2）。另外两个伤口在30分钟后分别冷却30分钟和3小时（分别为伤口3和伤口4）。
发现冷却剂的温度至关重要。当使用1 - 8摄氏度的冰水（第1组）时，观察到坏死情况比未冷却的伤口更多。当使用12 - 18摄氏度的自来水（第2组）时，临床和组织学结果均表明，冷却后的伤口坏死情况比未冷却的伤口少，因此愈合更快。在第2组中，即使延迟半小时进行冷却，其有益效果仍然存在。
用自来水对烧伤创面进行急救冷却是一种有效减少烧伤期间损伤的方法，且普遍可得且可立即使用。冰水冷却会导致组织损伤增加。
