Acute effects of local cold therapy in superficial burns on pain, in vivo microcirculation, edema formation and histomorphology

Burns. 2014 Aug;40(5):915-21. doi: 10.1016/j.burns.2013.11.023. Epub 2013 Dec 15.


Background: Local cold therapy for burns is generally recommended to relief pain and limit tissue damage, however, there is limited data of its physiological benefit. This study aimed to evaluate pathophysiological effects of cold therapy in superficial burn on microcirculation, edema formation, and histomorphology.

Methods: In 12 volunteers (8f, 4m; aged 30.4±14.1 years) circumscribed superficial burn was induced on both hand back and either left untreated as control (control-group) or treated by local-cold-application (cold-treatment-group). Prior to burn (t0), immediately (t1), 15 min (t2), and 30 min (t3) following cold therapy, following parameter was evaluated using intravital-microscopy; epidermal-thickness (ET), granular-cell-size (GCS), individual-blood-cell-flow (IBCF), and functional-capillary-density (FCD).

Results: Both ET and GCS increased significantly more in control-group and slightly in cold-treatment-group in t1, while turns to insignificant t2 onwards. IBCF and FCD raised up in control-group compared to dramatically decrease in cold-treatment-group in t1. In t2 both parameter remains in control-group and increased in cold-treatment-group. Comparison of both groups for IBCF and FCD indicates significant difference in t1 and t2, however, insignificant in t0 and t3.

Conclusions: Microcirculation, edema formation, and histomorphology of superficial burn has been significantly influenced through immediate cold therapy, however, this alterations are transient and turns to ineffective after 30 min.

Keywords: Blood flow; Burn cooling; Capillary density; Confocal microscopy; Epidermis; Human skin.

MeSH terms

  • Adolescent
  • Adult
  • Burns / complications
  • Burns / pathology
  • Burns / therapy*
  • Capillaries / pathology
  • Cryotherapy / methods*
  • Edema / etiology
  • Edema / prevention & control*
  • Epidermis / pathology
  • Female
  • Hand Injuries / pathology
  • Hand Injuries / therapy*
  • Humans
  • Male
  • Microcirculation*
  • Microscopy, Confocal
  • Middle Aged
  • Pain / etiology
  • Pain Management / methods*
  • Regional Blood Flow
  • Skin / blood supply
  • Skin / injuries*
  • Skin / pathology
  • Young Adult