Cooling the burn wound to maintain microcirculation.

To evaluate the effect which cooling of burn wounds has upon dermal microvascular circulation, standard 10% BSA dorsal guinea-pig scald burns were created. In treated animals, the dorsal burned region was immersed in a circulating ice-water bath (0-3 degrees C) for 30 minutes at various time intervals postburn (10,20,30, and 60 minutes after scald). India-ink perfusion was used to determine the level of dermal vessel patency at 2, 4, 8, 24, 72, and 96 hours after burning. By 96 hours, significant differences could be seen in animals cooled 10, 20, or 30 minutes after burning. Those not treated until 60 minutes after burning had dermal perfusion essentially the same as control animals. 133Xe dermal washout studies were performed at 8 and 24 hours and corroborated these findings. Grossly, burn wounds cooled by 30 minutes after burn had markedly better healing than control animals and animals cooled 60 minutes after burning. We believe these data support the early use of cold water treatment of partial-thickness burn wounds, as demonstrated in this experimental study.