There are many public health organizations with guidelines concerning the best first-aid treatment for burn injuries. The Australian and New Zealand Burn Association recommends that a burn wound should be cooled with tap water (8-20°C) for 20 minutes, up to three hours after the injury has occurred. However, the evidence that these guidelines are based on is inconclusive and contradictory. As a result of the conflicting published data, there is controversy over whether ice water or ice may confer any beneficial wound healing effects, and what temperature of water is optimal. In the wider community there are also many different alternative therapies believed to be beneficial for the treatment of burn injuries which do not have much evidence to support their use. In this study, patients were found to use agents such as Aloe vera, tea tree oil dressings, butter, toothpaste, papaya ointment and moisturizer on the burn wound. The aim of this work was to review the current field of first-aid treatment for burn injuries and obtain evidence for the optimum first aid treatment using a good animal model, with clinically relevant assessments of wound healing and scar formation. The mechanisms behind the best first aid treatment were also investigated in an effort to better understand and identify the factors involved in optimal wound healing. Studies showed that cool running water at 15°C and 2°C improved the speed of wound healing, gave a better cosmetic outcome and decreased amounts of scar tissue compared to untreated controls. Other treatments Aloe vera, tea tree oil dressings, ice and saliva did not improve wound healing compared to untreated controls. All cold treatments acted to decrease the subdermal temperature, however as the running water was beneficial for wound healing whereas the ice was not, this suggests that the running water acts through other non-thermal mechanisms. Further studies showed that immediate treatment with 15°C water for 20 minutes duration significantly improved the re-epithelialization for 2 weeks post-burn and decreased the distribution of scar tissue compared to untreated controls, however durations as short as 10 minutes and delays of treatment for 1 hour (and perhaps longer) were also beneficial. An audit of first aid used by pediatric patients demonstrated that although 86.1% of patients used first aid, only 12.1% applied the recommended first aid treatment of cold water for 20 or more minutes. For those that did use correct first aid, re-epithelialization time and number of hospital visits were significantly reduced for children with contact and flame burns, respectively. Inadequate first aid treatment was also found to be more common for children <3.5 years old and for friction burn injuries. These studies provide compelling evidence that correct first aid treatment of burn injuries results in improved clinical outcomes, which benefit the patient as well as health care providers. There is a definite need for greater public awareness concerning the correct first aid treatment to use for burn injuries.
| Identifer | oai:union.ndltd.org:ADTP/279255 |
| Creators | Leila Cuttle |
| Source Sets | Australiasian Digital Theses Program |
| Detected Language | English |
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