Burns and butter…

by Jim Caryl

Research blogging

An article published this month reviews first aid treatments for burn injuries (Cuttle et al. 2009. Burns: EPub). Having just attended my first-aid re-qualifier I thought I’d take a look.

Review outcome: use cold water (2–15 °C cold water applied for 20 min, if you’re interested)

So no surprises there then.

Amusingly, the reviewers mention that treatment for an acute burn injury was first documented in the Ebers Papyrus (c. 1500 BC):

Treatment involved applying to a burn “on the first day” a mixture of milk from a woman who had just given birth to a son, gum, and ram’s hair, together with a spoken incantation: “Your son Horus has burned himself in the desert. Is water here? There is no water here. Water is in my mouth, a Nile is between my thighs, I have come to put out the fire. Flow out, burn!”. Since that time in history where plant and animal extracts were popular, many other topical treatments have been used, such as vinegar and wine in Roman times, oily mixtures in the 1800s, tannic and picric acids from the early 1900s and finally cold water.

So, assuming you have no lactating women around, no gum, no choice snippets of hair from a Ram, then you can always rely on the incanted threat of having your burn spat on, or pissed on. Invariably over the years, you would be oiled, wined or burned with wood acid or an explosive. I wonder whether there is some sense of irony given that every remedy seems poised to complete the cooking of meat that you’ve already started, complete with some basting?

Finally we get to cold water that, according to the review, has the documented benefits of: decreasing mortality, pain relief, decreasing cell damage, decreasing skin temperature to below dangerous level, decreasing cell metabolism in hypoxic tissue for greater cell survival, stabilising vasculature, reducing oedema, improving wound healing and scar formation and decreasing inflammatory response.

The above is a victory for common sense, and documented evidence-based medicine, rather than the hocus of old. However, the review points out that there continues to be some controversy still as many people prefer the old ‘natural’ and ‘folk’ remedies, despite the lack of documented evidence that they do anything, and in many cases act to delay healing.

Cuttle, L., Pearn, J., McMillan, J., & Kimble, R. (2009). A review of first aid treatments for burn injuries Burns, 35 (6), 768-775 DOI: 10.1016/j.burns.2008.10.011

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