Rajan Vasant, Bartlett Nita, Harvey John G, Martin Hugh C O, La Hei Erik R, Arbuckle Susan, Godfrey Craig, Holland Andrew J A
Division of Surgery, The Children's Hospital Burns Research Institute and the Burns Unit, New South Wales, Australia.
J Burn Care Res. 2009 Jul-Aug;30(4):729-34. doi: 10.1097/BCR.0b013e3181ac059b.
The current Australia and New Zealand Burn Association recommended burns first aid treatment is to place the burn under cool running water for 20 minutes. Immediate cooling of a burn wound has been shown to reduce the depth of the injury. Cooling has also been recommended as beneficial for up to 3 hours after the burn. No scientific data currently exist to support this recommendation. The aim of this study was to identify the effect of delayed cooling of an acute scald contact burn wound in a porcine model. Four partial-thickness contact scald burn injuries were induced in 12 piglets each. First aid treatment consisting of cool running water for 20 minutes was instituted randomly to each wound at different time points: immediately and at time delays of 5, 20, and 60 minutes. The group receiving immediate first aid with cool running water for 20 minutes served as the control group. At day 1 and day 9, biopsies were obtained and assessed in a blinded manner. Histologic analysis of burn depth on days 1 and 9 demonstrated no significant difference in the depth of the burn in the various treatment groups in comparison to the control group receiving immediate first aid. No significant differences in the surface areas of each burn were noted between the various treatment groups on day 9. Core body temperature did not fall below 35 degrees C throughout the cooling process. This study provides scientific evidence that in an animal model delayed cooling for up to 60 minutes postacute contact scald burn is still effective compared with immediate cooling at reducing burn depth.
澳大利亚和新西兰烧伤协会目前推荐的烧伤急救治疗方法是将烧伤部位置于流动的冷水中冲洗20分钟。已证实立即对烧伤创面进行降温可减轻损伤深度。还有建议称，烧伤后长达3小时进行降温都是有益的。但目前尚无科学数据支持这一建议。本研究的目的是在猪模型中确定急性接触性烫伤创面延迟降温的效果。对12只仔猪各造成四处浅Ⅱ度接触性烫伤。在不同时间点对每个创面随机进行为期20分钟的流动冷水冲洗急救治疗：立即冲洗以及延迟5分钟、20分钟和60分钟后冲洗。接受立即用流动冷水冲洗20分钟急救治疗的组作为对照组。在第1天和第9天，以盲法获取活检样本并进行评估。第1天和第9天对烧伤深度的组织学分析表明，与接受立即急救的对照组相比，各治疗组的烧伤深度无显著差异。在第9天，各治疗组之间的每个烧伤创面面积均无显著差异。在整个降温过程中，核心体温未降至35摄氏度以下。本研究提供了科学证据，即在动物模型中，急性接触性烫伤后延迟长达60分钟降温与立即降温相比，在减轻烧伤深度方面仍然有效。
