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

Trial Summary

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 data supports the effectiveness of the treatment Water Spray and Fan, Water Spray and Fan, Skin Wetting and Fan Use, Evaporative Cooling Methods for burns?

Research shows that using cool running water or water spray can help reduce skin temperature and relieve pain in burn injuries. Sprayed coolants have been found to improve initial cooling in extensive burns, suggesting that water spray combined with fan use may enhance cooling and pain relief. ^{1 2 3 4 5}

Is cooling with water spray and fan safe for treating 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 without causing harm. ^{2 3 4 6 7}

How does the Water Spray and Fan treatment for burns differ from other treatments?

The Water Spray and Fan treatment for burns is unique because it combines water spray with fan use to enhance evaporative cooling, which can be more effective in reducing skin temperature compared to other methods like wet towels or burn-cooling blankets. This method leverages the cooling effect of evaporation, which is not as effectively utilized in treatments that rely solely on direct application of water or cooling products. ^{2 3 4 8 9}

What is the purpose of this trial?

This project will identify the efficacy of cooling modalities aimed to attenuate excessive elevations in skin and internal body temperatures, and associated indices of cardiovascular stress, during physical activity in well-healed burn survivors. The investigators will conduct a randomized crossover design study. Non-burned control subjects and subjects who experienced burns covering 20% or more of their body surface area will be investigated. Subjects will exercise in heated environmental conditions while receiving no cooling (control) as well as skin wetting.

Research Team

Craig G Crandall, PhD

Principal Investigator

UT Southwestern Medical Center

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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]

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]

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]

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]

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]

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]

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 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]

References

1. China pubmed.ncbi.nlm.nih.gov

[Influential factors of water evaporation from burn wound]. [2014]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Comparison of three cooling methods for burn patients: A randomized clinical trial. [2017]

3. England pubmed.ncbi.nlm.nih.gov

Assessment of cooling on an acute scald burn injury in a porcine model. [2018]

4. Netherlands pubmed.ncbi.nlm.nih.gov

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

5. Australia 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. [2022]

6. Switzerland pubmed.ncbi.nlm.nih.gov

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

7. England pubmed.ncbi.nlm.nih.gov

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

8. United States pubmed.ncbi.nlm.nih.gov

The effect of a commercially available burn-cooling blanket on core body temperatures in volunteers. [2006]

9. England pubmed.ncbi.nlm.nih.gov

The use of infrared radiation to reduce heat loss in burned patients: experiments with a phantom. [2019]