Thermal injury of skin and subcutaneous tissues: A review of experimental approaches and numerical models

Recent advances in inorganic nanomaterials for wound-healing applications

The emergence of inorganic nanoparticles has generated considerable expectation for solving various biomedical issues including wound healing and tissue regeneration. This review article highlights the role and recent advancements of inorganic nanoparticles for wound healing and tissue regeneration along with their advantages, clinical status, challenges and future directions.

Ultrasound elastography reliably identifies altered mechanical properties of burned soft tissues

Although burn injury to the skin and subcutaneous tissues is common in both civilian and military scenarios, a significant knowledge gap exists in quantifying changes in tissue properties as a result of burns. In this study, we present a noninvasive technique based on ultrasound elastography which can reliably assess altered nonlinear mechanical properties of a burned tissue. In particular, ex vivo porcine skin tissues have been exposed to four different burn conditions: (i) 200°F for 10s, (ii) 200°F for 30s, (iii) 450°F for 10s, and (iv) 450°F for 30s. A custom-developed instrument including a robotically controlled ultrasound probe and force sensors has been used to compress the tissue samples to compute two parameters (C₁₀ and C₂₀) of a reduced second-order polynomial hyperelastic material model. The results indicate that while the linear model parameter (C₁₀) does not show a statistically significant difference between the test conditions, the nonlinear model parameter (C₂₀) reliably identifies three (ii-iv) of the four cases (p<0.05) when comparing burned with unburned tissues with a classification accuracy of 60-87%. Additionally, softening of the tissue is observed because of the change in structure of the collagen fibers. The ultrasound elastography-based technique has potential for application under in vivo conditions, which is left for future work.

Modeling Skin Injury from Hot Rice Porridge Spills

The present work analyzes skin burns from spills of hot rice and milk products. The traditional Norwegian rice porridge serves as an example. By testing spills on objects emulating an arm, it was concluded that spills were seldom thinner than 3 mm, and stayed in place due to the viscosity of the porridge for more than one minute. The Pennes bioheat equation was solved numerically for such spills, including heat conduction to the skin and convective heat losses from the porridge surface. Temperatures were analyzed in the porridge and skin layers, and the resulting skin injury was calculated based on the basal layer temperature. Parameters influencing burn severity, such as porridge layer thickness, porridge temperature, removal of the porridge and thermal effects of post scald tempered (15 °C) water cooling were analyzed. The spilled porridge resulted in a prolonged heat supply to the skin, and the skin injury developed significantly with time. The porridge temperature turned out to be the most important injury parameter. A 70 °C porridge temperature could develop superficial partial-thickness burns. Porridge temperatures at processing temperatures nearly instantly developed severe burns. It was demonstrated that prompt removal of the hot porridge significantly reduced the injury development. The general advice is to avoid serving porridge and similar products at temperatures above 65 °C and, if spilled on the skin, to remove it quickly. After such scald incidents, it is advised to cool the injured area by tempered water for a prolonged period to stimulate healing.

Modeling Skin Injury from Hot Spills on Clothing

The present work analyzes scald burns from hot beverages, such as coffee and tea, spilled on the lap, i.e., an incident that may occur in daily life. The Pennes bioheat equation is solved numerically for small spills wetting the clothing, i.e., the fabric prevents the spilled liquid from draining away. Temperatures are analyzed in the wetted fabric and the skin layers and the resulting skin injury is calculated based on the basal layer temperature. Parameters influencing burn severity, such as clothing thickness, liquid temperature, removal of fabric and thermal effects of post scald water cooling are analyzed. The fabric cools the water some but represents a threat since the entrapped water results in a prolonged heat supply. The liquid temperature turned out to be the most important injury parameter, where liquid temperature of about 80–85 °C seems to be a limit for developing superficial partial-thickness burns in the present minimum case, i.e., where the liquid just wets the fabric. Spilling water in excess of just wetting the fabric, more severe burns will develop at lower liquid temperatures due to the prolonged heat supply. Higher liquid temperatures will nearly instantly develop more severe burns. It is demonstrated that removal of the clothing within the first seconds after the spill may significantly reduce the scalding severity. The general advice is therefore to avoid excessive heating of beverages and, if the beverage is spilled, to quickly remove the wetted clothing. Prolonged tempered water cooling is advised to improve the healing processes.

Modeling Burns for Pre-Cooled Skin Flame Exposure

On a television show, a pre-cooled bare-skinned person (TV host) passed through engulfing kerosene flames. The assumption was that a water film should protect him during 0.74 s flame exposure in an environment of 86 kW/m² heat flux. The TV host got light burn inflammation on the back, arms and legs. The present work studies skin temperatures and burn damage integral of such dangerous flame exposure. The skin temperature distribution during water spray pre-cooling, transport to the flames, flame exposure, transport to the water pool, and final water pool cooling is modelled numerically. Details of the temperature development of the skin layers are presented, as well as the associated damage integral. It is shown that 5 °C water spray applied for a 30 s period pre-cooled the skin sufficiently to prevent severe skin injury. Soot marks indicate that the water layer evaporated completely in some areas resulting in skin flame contact. This exposed dry skin directly to the flames contributing significantly to the damage integral. It is further analyzed how higher water temperature, shorter pre-cooling period or longer flame exposure influence the damage integral. It is evident that minor changes in conditions could lead to severe burns and that high heat flux levels at the end of the exposure period are especially dangerous. This flame stunt should never be repeated.