Effect of early burn wound cooling with tap water and hydrogel on clinical outcomes in scald injuries.

Aydogan, Cem; Erkent, Murathan; Abali, Ayşe Ebru; Kuru, Elif Tuna; Gojajev, Afig; Avcı, Tevfik; Haberal, Mehmet · Burns · 2026

retrospective_cohort · Level III

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Abstract

This study aimed to assess the effects of first aid methods, including early burn wound cooling with running tap water and/or Burnshield® hydrogel, versus no treatment or inappropriate first aid on clinical outcomes in patients with scald burns. In this single-center retrospective analysis, we compared cooling first aid (defined as cooling with running tap water and/or hydrogel within 8 h after injury) with inappropriate or no first aid in 2566 patients with scald burns. Outcomes included time to complete epithelialization, surgical debridement, split-thickness skin grafting, systemic antibiotic use, hospitalization, age-stratified effects (pediatric/adult/geriatric), the effect of combining water with hydrogel, and timing of hospital admission. Overall, 73.4% of patients received cooling first aid. Median healing time was significantly shorter in the cooling first aid group 11 (8-14) days compared with the inappropriate first aid group 16 (12-23) days and the no first aid group 16 (12.25-23) days (p < 0.001). Cooling first aid was also associated with lower rates of debridement (17.05%), grafting (5.20%), systemic antibiotic use (11.84%), and hospitalization (17.26%) compared with inappropriate or no first aid (all p < 0.001). Median healing time differed by age group, with values of 12 (8-15) days in pediatric patients, 12 (8-15) days in adults, and 17 (12-23) days in geriatric patients (p < 0.001). The combination of tap water plus hydrogel yielded the shortest median healing time 10 (7-13) days and the lowest intervention rates. Admission within 24 h was associated with significantly better outcomes than later admission. Early cooling first aid substantially improves clinical outcomes in patients with scald burns. These findings support the effectiveness of hydrogel-based cooling as an adjunct to water irrigation and highlight the need for widespread public education on evidence-based first aid practices.