The Experiment On Relieving The Local Symptoms Of The Early Burned Wound With The Method Of Cooling Combined With Spraying Film

BackgroudWound treatment,as an important part of burn remedy,is run through the entire treating process.Early wound treatment,which is the initial stage of burn remedy,will play an important effect on the follow-up treatment if it has been carried out timely and effectively.After burning,the continual pain and edema will cause a series of pathological and physiological changes.As the development of medical philosophy and the increasing demand to relieve pain,the analgesic treatment which is an important component of the clinical treatment attracts people's attention gradually.Opioid and non-opioid analgesic drugs is the primary means of treatment,and some non-pharmacological analgesic treatment methods has also been used in clinical treatment.Due to the limited treatment conditions in the scene of the burning accident and the side-effects of analgesic drug side-effects,it is difficult for clinical analgesic methods to be applicated in the stage of pre-hospital.Tissular edema after burn injury is another local prominent symptom, and abnormal vascular permeability changes,oxygen free radicals and inflammatory cytokinesthose are important factors in the occurrence and development of tissular edema.Currently,the treatment for relieving edema has a poor effect,because a number of factors promote edema formation and it is difficult for Clinical medicine to apply in the pre-hospital.Cooling,which is a traditional first-aid measures for burns,Can effectively ease the pain and alleviate edema,regardless of a shorter duration. Spraying film is a method for burn treatment over the past decade.However,the first aid for burns has been not reported in the literature.The effects of cooling combined with spraying film were reported rarely in the literature,and its mechanism is not yet clear.Objectives1.To evaluate the effect of cooling combined with spraying film to treat the early scalded wound on the pain and edema.2.To investigate the mechanism of easing pain and relieving the wound edema with cooling combined with spraying film to treat the early scalded wound.Materials and Methods1.groups:Seventy-five SPF Wistar rats,male and female open,weights(180±5)g, supplied by Nanfang hospital,were randomly divided into the following five groups F,N,A,B,C,and there were fifteen rats per group.Group F were not scalded and untreated.Group N,were untreated.Group A,wounds were immerged in water,which temperature was 15℃,for 30 minutes.Group B,wounds were sprayed with film solvent.Group C,wounds were sprayed with film solvent firstly,then were immerged in water,which temperature was also 15℃,for 30 minutes.Then fifteen rats in different groups were randomly divided into 0.5h,1h and 2h time points,five rats at per time point. 2.Model:The day before scalded,pelage on rats' right hind leg was cut by scissor,depilated by 10%sodium sulfide.Rats were fixed strongly and their right thigh were exposed completely before scalded.Then 4%TBSA superficial second scalded wound of each rat was conducted by water,temperature of which was 99℃,for 3s.In sham scalded group(group F),the process was the same,but the water temperature was 37℃.3.Test indeces and methods:Observing rats' behavior after treatment for 0.5h,1h and 2h,on the basis of behavioral score standards.prostaglandin E₂(PGE₂) levels in wound tissue andβ-EP levels in blood were measured by radioimmunoassay(RIA).NE levels in blood were measured by HPLC-ECD.The total tissular water content was measured by wet:dry weight ratios.Killing rats at the 1h time points after burns,taking out the spinal cord segments L4-5,then the spinal cords were stained immunohistochemically,SP were detected by Image Analyzer.4.Statistical analysis:All the parameters were expressed as the mean±standard deviation(SD) respectively.SP levels were analyzed by one-way ANOVA method. Pain score,PGE₂ levels,β-EP levels,NE levels and the total tissular water content were analyzed by factorial analysis,with SNK-q for two-two comparison.Takingα=0.05 (two tail) as inspection standards,P＜0.05 as significance level.All the statistic analysis was performed in SPSS 13.0 software.Results1.The changes of wound tissular water content and PGE₂ content:At 1h time point after burned,water content and the content of PGE2 in wound tissue were increased rapidly.the indices in group C were the smallest increase,and a larger increase in group A and group B,There was signigicant different between the above groups(P＜0.05).At 1.5h and 2.5h time points after burned,those indices showed an upward trend.Comparison among different groups showed that those indices were the lowest in group C,and were the highest in group N,Both group A and group B were between group C and group N,There was signigicant different between the above groups(P＜0.05).Between group A and group B,there was not significant difference (P＞0.05).2.The changes of level ofβ-EP and NE in the plasma:At 1h time point after burned,level ofβ-EP and NE in the plasma increase rapidly.the indices in group C were the smallest increase,have a larger increase in group A and group B,There was signigicant different between the above groups(P＜0.05).At 1.5h and 2.5h time points after burned,those indices showed an upward trend.Comparison among different groups showed that those indices were the lowest in group C,and were the highest in group N,Both group A and group B were between group C and group N,There was signigicant different between the above groups(P＜0.05).Between group A and group B,there was not significant difference(P＞0.05).3.Pain score:At 1h time point after burned,pain score increase rapidly.Those indices in group C has the smallest increase,have a larger increase in group A and group B,That is significant difference(P＜0.05).At 1.5h and 2.5h time points after burned,those indices showed an upward trend.Comparison among different groups showed that those indices were the lowest in group C,and were the highest in group N, Both group A and group B were between group C and group N,There was signigicant different between the above groups(P＜0.05).Between group A and group B,there was not significant difference(P＞0.05).4.SP content in spinal dorsal horn at 1h time point after injury:SP content in spinal dorsal horn decrease rapidly.That indices in group C has the smallest decrease, have a larger decrease in group A and group B,There was signigicant different between the above groups(P＜0.05).Between group A and group B,there was not significant difference(P＞0.05). Conclusions1.Cooling combined with spraying film on the early scalded wound can effectively ease the pain and relieve the wound edema effectively,compared with cooling.2.The mechanism of cooling and cooling combined with spraying film ease the pain and relieve the wound edema is related to reducing the wound inflammatory respons.3.The mechanism of cooling combined with spraying film ease the pain and relieve the wound edema was maybe that it can protect the exposured and injuried nerve endings,relieve trauma response and reduce stress hormones,such asβ-EP and NE in plasma.