Cooling Methods for Burns

Overseen By Craig G Crandall, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas Southwestern Medical Center

Disqualifiers: Heart disease, Cancer, Diabetes, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 2

36 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests whether cooling methods, such as water spray and fans, reduce body heat and heart stress in individuals with severe burns. Participants will exercise in the heat both without and with cooling to determine which method is most effective. The trial is open to healthy individuals, either those without burns or those who have experienced burns covering 20% or more of their body. Burn survivors must have required skin grafts for at least half of their burns and have been hospitalized for at least 15 days. As an unphased trial, this study allows participants to contribute to innovative research that could enhance recovery methods for burn survivors.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but it excludes people with chronic medical conditions requiring regular therapy, like heart disease, cancer, diabetes, and hypertension.

What prior data suggests that these cooling methods are safe for burn survivors?

Research has shown that cooling methods, such as spraying water and using a fan, are generally safe for treating burn injuries. These methods lower skin temperature and reduce pain, benefiting those with burns. Current guidelines agree that water cooling can lessen cell damage and reduce wound size. No major safety concerns have been reported with these techniques, and they are well-tolerated by both healthy individuals and those with burns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the trial for cooling methods for burns because it explores the effectiveness of water spray and fan cooling in managing heat stress, potentially offering a simple and accessible approach for burn survivors. Unlike traditional burn treatments that often involve dressings, ointments, or surgical interventions, this method focuses on physical cooling techniques, which could be less invasive and more immediate. By examining non-burned individuals alongside burn survivors, the trial aims to uncover broader applications and effectiveness, potentially leading to new guidelines for managing heat exposure in vulnerable populations.

What evidence suggests that these cooling methods are effective for managing heat stress in burn survivors?

Research has shown that using water spray and fans can effectively cool the skin and body. One study found that frequent water spraying helps maintain a lower core body temperature during exercise in hot weather. In this trial, participants, including both non-burned individuals and burn survivors, will either receive no cooling or cooling through skin wetting while exercising in the heat. Cooling the skin with water can also ease pain and reduce the need for surgery in burn injuries. These methods are generally safe and help reduce stress on the heart during exercise. Overall, using water spray and fans can make exercising in the heat more comfortable, especially for those recovering from burns. ^{1 6 7 8 9}

Who Is on the Research Team?

Craig G Crandall, PhD

Principal Investigator

UT Southwestern Medical Center

Are You a Good Fit for This Trial?

This trial is for individuals who have survived burns covering at least 20% of their body and are now well-healed. They will participate in exercise under heated conditions to test cooling methods. Non-burned individuals can also join for comparison.

Inclusion Criteria

I am a healthy adult between 18 and 65 with no medical conditions.

I am a healthy adult aged 18-65 with burns covering 20% of my body, half of which were severe enough to need skin grafts, and I was hospitalized for at least 15 days.

Exclusion Criteria

Burn Survivors: Any burn-related injuries resulting in at least one night of hospitalization, heart disease or any other chronic medical condition requiring regular medical therapy including cancer, diabetes, and hypertension, abnormalities detected on routine screening, individuals who participate in a structured aerobic exercise training program at moderate to high intensities, current smokers, as well as individuals who regularly smoked within the past 3 years, body mass index of greater than 30 kg/m^2, pregnant individuals, extensive unhealed injured skin

Non-Burned Individuals: Any burn-related injuries resulting in at least one night of hospitalization, heart disease or any other chronic medical condition requiring regular medical therapy including cancer, diabetes, and hypertension, abnormalities detected on routine screening, individuals who participate in a structured aerobic exercise training program at moderate to high intensities, current smokers, as well as individuals who regularly smoked within the past 3 years, body mass index of greater than 30 kg/m^2, pregnant individuals

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Exercise Intervention

Participants exercise in heated conditions with and without cooling interventions

60 minutes per session

2 sessions (in-person)

Follow-up

Participants are monitored for changes in cardiac and temperature responses post-exercise

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Water Spray and Fan

Trial Overview The study aims to see if using a fan and water spray can prevent overheating and reduce heart stress during exercise in a hot environment, compared to no cooling. It's a randomized crossover design, meaning all participants will try both methods.

How Is the Trial Designed?

Group I: Non-Burned Individuals Experimental Treatment 2 Interventions

Non-burned individuals will exercise for 60 minutes in the heat while being exposed to either no cooling or cooling via skin wetting (two trials).

Group II: Burn Survivors (20% or more Burn Surface Area burn-injured) Experimental Treatment 2 Interventions

Burn survivors with 20% or more BSA (burn surface area) burn-injured will exercise for 60 in the heat while being exposed to either no cooling or cooling via skin wetting (two trials).

Who Is Running the Clinical Trial?

University of Texas Southwestern Medical Center

Lead Sponsor

Trials

1,102

Recruited

1,077,000+

Published Research Related to This Trial

In a pilot study with 53 healthy participants, spraying 1 liter of coolant was found to cool the skin more effectively and uniformly than pouring 5 liters of water over burns, especially in the first 9 minutes.

Neither method caused hypothermia, indicating that spraying coolant is a safe and efficient technique for the initial management of extensive burns.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cooling extensive burns: sprayed coolants can improve initial cooling management - a thermography-based study. Schnell, HM., Zaspel, JG.[2013]

Using a commercially available cooling blanket for 30 minutes does not lower core body temperatures in healthy adults, indicating it is safe and does not cause hypothermia.

The cooling blanket effectively reduces water evaporation from containers, suggesting it may help maintain moisture in burn treatment scenarios.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of a commercially available burn-cooling blanket on core body temperatures in volunteers. Singer, AJ., Freidman, B., Modi, P., et al.[2006]

In a study of 4537 children with thermal burn injuries, 71.9% received adequate first aid, defined as 20 minutes of cool running water within 3 hours of the injury, highlighting a significant gap in initial treatment practices.

Only a small percentage of paramedics (25.0%) and general practitioners (24.2%) provided adequate cooling, indicating a need for better education and adherence to guidelines among healthcare professionals in managing pediatric burn injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Adequacy of cool running water first aid by healthcare professionals in the treatment of paediatric burns: A cross-sectional study of 4537 children. Frear, CC., Griffin, B., Kimble, R.[2022]

In a study involving 96 burn patients, tap water was found to be the most effective method for cooling burn wounds, significantly reducing skin surface temperature more than Burnshield® and Burn Cool Spray®.

All three cooling methods effectively reduced pain levels, but tap water and Burn Cool Spray® were more effective than Burnshield®, with the effectiveness of tap water being influenced by its temperature and the timing of treatment after the burn occurred.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of three cooling methods for burn patients: A randomized clinical trial. Cho, YS., Choi, YH.[2017]

Patients with severe burns initially have cooler wound temperatures compared to intact skin, but these wounds warm up to skin temperature within three days post-injury, which is important for recovery.

Fluid evaporation from burn wounds significantly increases heat loss, and patients with larger burns sweat less, indicating that temperature management in their environment is crucial for preventing excessive heat loss.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A study of skin temperatures, sweat rate and heat loss for burned patients. Ferguson, JC., Martin, CJ.[2019]

In a study using a phantom model to simulate burned tissue, it was found that humidity and air velocity significantly influence the evaporation rate from the skin, which is crucial for managing heat loss in burn patients.

Using infrared radiation can effectively reduce the internal energy needed to maintain skin temperature, allowing for better thermal management and comfort for patients while compensating for heat lost through evaporation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The use of infrared radiation to reduce heat loss in burned patients: experiments with a phantom. Bowker, P., Martin, CJ., Fulton, D., et al.[2019]

In a study involving 120 rats with burn wounds, it was found that higher temperatures and lower moisture levels increased the rate of water evaporation, which could impact wound healing.

Treatment methods like escharectomy, skin grafting, and the use of film-forming agents were effective in reducing water evaporation from burn wounds, while Azone increased skin permeability and accelerated evaporation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Influential factors of water evaporation from burn wound]. Guo, ZR., Diao, L., Sheng, ZY.[2014]

A pre-cooling method using a 5 °C water spray for 30 seconds can significantly reduce the risk of severe skin injury during brief flame exposure, as demonstrated by a TV host's experience with light burns after a 0.74-second exposure to flames.

The study highlights that even minor changes in conditions, such as higher water temperature or longer flame exposure, can drastically increase the risk of severe burns, emphasizing the dangers of high heat flux levels.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Modeling Burns for Pre-Cooled Skin Flame Exposure. Log, T.[2023]

In a study involving 10 piglets with induced partial-thickness scald burns, cool running water applied for 20 minutes was found to be the most effective first aid treatment, leading to consistent improvement in wound recovery over 9 days.

In contrast, the use of wet towels and water spray showed variable results, while the control group without treatment experienced worsening of the burn, highlighting the importance of using cool running water for burn first aid.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Assessment of cooling on an acute scald burn injury in a porcine model. Yuan, J., Wu, C., Holland, AJ., et al.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC11023434/

5 Water Spray Attenuates Increases in Core Temperature ... These data demonstrate that skin wetting, via frequent water spraying, is effective in attenuating elevations in Tcore during physical activity in warm and ...

2. withpower.com withpower.com/trial/cooling-methods-for-burns-192ec

Cooling Methods for Burns Research shows that cooling methods like water spray and fan are generally safe for treating burns, as they help reduce skin temperature and relieve pain ...

3. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/35688782/

The effect of 20 minutes of cool running water first aid ... Twenty minutes of CRW within the first three hours of burn injury significantly decreased the odds of patients requiring skin grafting and surgical ...

4. sciencedirect.com sciencedirect.com/science/article/pii/S0735193325011236

A new cooling strategy concept based on water pulses for ... In this work, a novel way to cool down the firefighter after a heat exposure is outlined. The method utilizes the concept of water pulse cooling, taking ...

5. researchgate.net researchgate.net/publication/361154504_The_effect_of_20_minutes_of_cool_running_water_first_aid_within_three_hours_of_thermal_burn_injury_on_patient_outcomes_A_systematic_review_and_meta-analysis

The effect of 20 minutes of cool running water first aid ... Twenty minutes of CRW within the first three hours of burn injury significantly decreased the odds of patients requiring skin grafting and ...

6. ncbi.nlm.nih.gov ncbi.nlm.nih.gov/books/NBK541209/

Cooling for Thermal Burns: Clinical Effectiveness and ... - NCBI Current guidelines generally agree that cooling with running water is effective in mitigating cell damage and reducing wound size.

7. sciencedirect.com sciencedirect.com/science/article/pii/S2093791125000344

Ineffectiveness of Water Mist Spray to the Upper Body ... Global warming has increased heat-related illness concerns. Water misting is used for workplace cooling, but its effect on core body temperature is unclear.

8. nationwidechildrens.org nationwidechildrens.org/family-resources-education/health-wellness-and-safety-resources/helping-hands/burn-prevention-teenage-and-adult

Burn Prevention: Teens and Adults If you have been burned, apply cool water to the area for 20 minutes. Do not use ice or ice water on the burn. Internet and Social Media Warning. Always ...

9. cdc.gov cdc.gov/infection-control/hcp/environmental-control/water.html

D. Water | Infection Control Moist environments and aqueous solutions in health-care settings have the potential to serve as reservoirs for waterborne microorganisms.