Demling R H, Mazess R B, Wolberg W
J Trauma. 1979 Jan;19(1):56-60. doi: 10.1097/00005373-197901000-00011.
Massive wound edema after a burn may impair healing and help to convert partial to full-thickness injury. Cold treatment (usually by immersion) has been reported to decrease wound edema and is useful in first-aid treatment of burns. Reliable quantitative data have been lacking and frequently a superficial burn has been studied. Since cold by decreasing peripheral blood flow could actually be harmful to a deep burn, especially if applied late, we measured the effect of cold immediately and 2 minutes postburn on edema formation and resorption in a deep second-degree burn in sheep hindlimbs. We used Dichromatic Absorptiometry, a noninvasive, reliable method for measuring tissue fluid, to quantitate edema. Immediate application of cold by immersion in 15 degrees C saline for 30 minutes reduced the edema of a deep second-degree burn and did not impair resorption rate compared with control limbs, fluid content returning to baseline after 1 week. Cold treatment beginning 2 minutes after the burn did not decrease edema formation and did impair resorption. Fifteen per cent of the edema fluid was still present 1 week postburn, suggesting further injury to the burn wound vasculature with use of cold immersion 2 minutes postburn.
烧伤后大面积伤口水肿可能会妨碍愈合，并促使浅度烧伤转变为深度烧伤。据报道，冷疗（通常采用浸泡方式）可减轻伤口水肿，对烧伤的急救治疗很有用。一直以来都缺乏可靠的定量数据，而且经常研究的是浅度烧伤。由于冷疗通过减少外周血流实际上可能对深度烧伤有害，尤其是在晚期应用时，我们测量了在绵羊后肢深二度烧伤后立即及烧伤后2分钟冷疗对水肿形成和吸收的影响。我们使用双色吸收光度法（一种测量组织液的非侵入性可靠方法）来定量水肿。与对照肢体相比，立即将烧伤肢体浸泡在15摄氏度盐水中30分钟进行冷疗可减轻深二度烧伤的水肿，且不影响吸收速率，1周后液体含量恢复至基线水平。烧伤后2分钟开始冷疗并未减少水肿形成，反而影响了吸收。烧伤后1周仍有15%的水肿液存在，这表明在烧伤后2分钟使用冷浸疗法会对烧伤伤口血管造成进一步损伤。
