Cho Young Soon, Choi Young Hwan
Department of Emergency Medicine, College of Medicine, Soonchunhyang University, Republic of Korea.
Department of Emergency Medicine, Bestian Hospital, Republic of Korea.
Burns. 2017 May;43(3):502-508. doi: 10.1016/j.burns.2016.09.010. Epub 2016 Oct 1.
Tap water may not be readily available in numerous places as a first aid for burns and, therefore, tea tree oil products are recommended alternatives. Our aim in this study was to compare the cooling effects of three burn-cooling methodologies, running tap water, Burnshield, and Burn Cool Spray, and suggest indications for each cooling method. This randomized, controlled, study enrolled patients with burns who used the emergency service of Seoul Bestian Hospital from June 2015 to October 2015. The allocation of the cooling methods was randomly generated using a computer. We cooled the burn wounds by applying one of the three methods and measured the skin surface temperature and pain level using a visual analog scale (VAS) scoring. Ninety-six patients were enrolled in this study. The variability in the median(IQR) skin temperatures of the three groups was from 33.5°C (31.5-35.0) to 28.7°C (25.9-30.9), 33.8°C (32.0-35.4) to 33.2°C (30.5-35.0), and 34.0°C (32.0-35.1) to 34.4°C (32.7-35.6) for the tap water, Burn Cool Spray, and Burnshield, respectively. The variability of the mean VAS pain scores was 6.9 to 4.8 (tap water), 5.6 to 4.5 (Burn Cool Spray), and 5.5 to 3.3 (Burnshield). The reduction of skin surface temperature by tap water was significantly greater than that by the other two methods. All three methods reduced the VAS pain score after 20min of treatment (p<0.001). The tap water had a similar effect to that of the Burn Cool Spray but significantly better than that of Burnshield. There was a significant difference in the skin surface temperature and VAS pain score reduction (p=0.014 and p=0.007, respectively) between the groups cooled by tap water below and above 24°C. The patients who visited the center within 30min showed a significantly higher skin temperature than those who came after 30min did (p=0.033). Tap water and Burn Cool Spray reduced the skin surface temperature, but the Burnshield slightly increased it. All three cooling methods were effective in relieving pain. The temperature of the tap water used was related to the reduction in skin surface temperature and VAS pain score. The patients who visited the hospital within 30min of their burn accident needed a longer cooling time to attain a comparable skin surface temperature to those who visited after 30min.
在许多地方，自来水可能无法随时作为烧伤急救的水源，因此，茶树油产品是推荐的替代选择。本研究的目的是比较三种烧伤冷却方法（流动的自来水、Burnshield和Burn Cool喷雾）的冷却效果，并为每种冷却方法提出适用指征。这项随机对照研究纳入了2015年6月至2015年10月期间在首尔贝斯提安医院急诊就诊的烧伤患者。冷却方法的分配通过计算机随机生成。我们通过应用三种方法之一对烧伤创面进行冷却，并使用视觉模拟量表（VAS）评分来测量皮肤表面温度和疼痛程度。本研究共纳入96例患者。三组患者皮肤温度中位数（四分位间距）的变化范围分别为：自来水组从33.5°C（31.5 - 35.0）降至28.7°C（25.9 - 30.9），Burn Cool喷雾组从33.8°C（32.0 - 35.4）降至33.2°C（30.5 - 35.0），Burnshield组从34.0°C（32.0 - 35.1）降至34.4°C（32.7 - 35.6）。平均VAS疼痛评分的变化分别为：自来水组从6.9降至4.8，Burn Cool喷雾组从5.6降至4.5，Burnshield组从5.5降至3.3。自来水使皮肤表面温度降低的幅度显著大于其他两种方法。所有三种方法在治疗20分钟后均降低了VAS疼痛评分（p<0.001）。自来水的效果与Burn Cool喷雾相似，但显著优于Burnshield。在24°C以下和以上用自来水冷却的组之间，皮肤表面温度和VAS疼痛评分降低存在显著差异（分别为p = 0.014和p = 0.007）。在烧伤事故后30分钟内就诊的患者皮肤温度显著高于30分钟后来就诊的患者（p = 0.033）。自来水和Burn Cool喷雾降低了皮肤表面温度，但Burnshield使其略有升高。所有三种冷却方法在缓解疼痛方面均有效。所用自来水的温度与皮肤表面温度和VAS疼痛评分的降低有关。烧伤事故后30分钟内就诊的患者需要更长的冷却时间才能达到与30分钟后来就诊的患者相当的皮肤表面温度。
