Human model of burn injury that quantifies the benefit of cooling as a first aid measure

ANTECEDENTES: Las lesiones por quemadura son una causa importante de morbilidad y mortalidad en todo el mundo. El enfriamiento de las quemaduras se practica ampliamente como medida de primeros auxilios, pero no se ha demostrado su eficacia en la piel de los seres humanos. Para cuantificar los efectos del enfriamiento, se desarrollo un modelo de quemadura y enfriamiento en piel humana in vivo, seguro, estable y eticamente aceptable. METODOS: Se construyo un dispositivo nuevo para crear y enfriar quemaduras en pacientes que fueron anestesiadas para una reconstruccion mamaria utilizando un colgajo perforante de la arteria epigastrica inferior profunda. Las quemaduras se extirparon entre una y tres horas despues de su produccion y se analizaron por evaluacion histopatologica. Para determinar la significacion estadistica entre grupos se utilizo las pruebas de ANOVA o de t pareadas, segun correspondiera. METHODS: Novel apparatus was manufactured to create and cool burns in women who were anaesthetized for breast reconstruction surgery using a deep inferior epigastric artery perforator flap. Burns were excised between 1 and 3 h after creation, and analysed using histopathological assessment. RESULTS: All 25 women who were approached agreed to take part in the study. There were no adverse events. Increased duration of contact led to increased burn depth, with a contact time of 7·5 s at 70°C leading to a mid-dermal burn. Burn depth progressed over time following injury, but importantly this was modified by cooling the burn at 16°C for 20 min. On average, cooling salvaged 25·2 per cent of the dermal thickness. CONCLUSION: This study demonstrated the favourable effects of cooling on human burns. Public heath messaging should emphasize cooling as first aid for burns. This model will allow analysis of the molecular effects of cooling burns, and provide a platform for testing novel therapies aimed at reducing the impact of burn injury.