Van de Sompel Dominique, Kong Tze Yean, Ventikos Yiannis
Department of Engineering Science & Institute of Biomedical Engineering, University of Oxford, Parks Road, Oxford OX1 3PJ, United Kingdom.
Med Eng Phys. 2009 Jul;31(6):624-31. doi: 10.1016/j.medengphy.2008.11.016. Epub 2009 Jan 4.
Rapid post-injury cooling of a skin burn has been shown to have both symptomatic and therapeutic benefits. However, the latter cannot be explained by temperature reduction alone, and must thus be secondary to an altered biological response. In this study, we construct a computational model to calculate the heat transfer and damage accumulation in human skin during and after a burn. This enables us to assess the effectiveness of various cooling protocols (involving both free and forced convection to air and water respectively) in terms of their reduction in Arrhenius tissue damage. In this process, we propose an extension of the Arrhenius damage model in the form of a new measure xi, which estimates the relevance of post-burn accrued damage. It was found that the reduction in Arrhenius damage integrals near the skin surface was too small to be physiologically relevant. Hence our results confirm that while the reduction in tissue temperatures is indeed quicker, the therapeutic benefit of cooling cannot be explained by thermal arguments (i.e. based on Arrhenius damage models) alone. We plan to validate this hypothesis by conducting future microarray analyses of differential gene expression in cooled and non-cooled burn lesions. Our computational model will support such experiments by calculating the necessary conditions to produce a burn of specified severity for a given experimental setup.
皮肤烧伤后迅速降温已被证明具有缓解症状和治疗的双重益处。然而，后者不能仅通过温度降低来解释，因此必然继发于生物反应的改变。在本研究中，我们构建了一个计算模型，以计算烧伤期间及之后人体皮肤中的热传递和损伤累积。这使我们能够根据各种冷却方案（分别涉及空气和水的自然对流与强制对流）在降低阿累尼乌斯组织损伤方面的效果进行评估。在此过程中，我们提出以新度量xi的形式扩展阿累尼乌斯损伤模型，该度量估计烧伤后累积损伤的相关性。结果发现，皮肤表面附近阿累尼乌斯损伤积分的降低过小，在生理上不具有相关性。因此，我们的结果证实，虽然组织温度的降低确实更快，但冷却的治疗益处不能仅通过热学论据（即基于阿累尼乌斯损伤模型）来解释。我们计划通过对冷却和未冷却烧伤创面进行差异基因表达的未来微阵列分析来验证这一假设。我们的计算模型将通过计算给定实验设置下产生特定严重程度烧伤的必要条件来支持此类实验。
