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

Background Burn injuries are a major cause of morbidity and mortality worldwide. Cooling is widely practised as a first aid measure, but the efficacy of cooling burns in human skin has not been demonstrated. A safe, consistent, ethically acceptable model of burning and cooling in live human skin in vivo was developed, and used to quantify the effects of cooling. 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. 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 desarrolló un modelo de quemadura y enfriamiento en piel humana in vivo, seguro, estable y éticamente aceptable. Métodos Se construyó un dispositivo nuevo para crear y enfriar quemaduras en pacientes que fueron anestesiadas para una reconstrucción mamaria utilizando un colgajo perforante de la arteria epigástrica inferior profunda. Las quemaduras se extirparon entre una y tres horas después de su producción y se analizaron por evaluación histopatológica. Para determinar la significación estadística entre grupos se utilizó las pruebas de ANOVA o de t pareadas, según correspondiera. Resultados Aceptaron participar en el estudio las 25 pacientes a las que se propuso. No hubo efectos adversos. La mayor duración del contacto conllevó un aumento en la profundidad de l