CA1197192A - Burn treatment composition - Google Patents

Abstract

BURN TREATMENT COMPOSITION

ABSTRACT
This invention relates to a composition which is useful in the treatment and healing of thermal, chemical and ultraviolet skin burns and skin irritants such as insect bites, and stings of jelly-fish and nettles. The composition comprises: (a) one part ammonium carbonate, or an ambient equilibrium mixture of ammonium carbonate, ammonium carbamate, and ammonium bicarbonate (with or without the presence of urea), and (b) five to twenty parts of a suitable carrier such as water.

Description

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BURN TREA~MENT COMPOSITION

FIELD OF THE IN~ENTION
This invention relates to a substance which is useful in the treatment and healing of thermal, chemical and ultra violet skin burns, frost bite, and skin irritants such as insect bites and stings of jelly-fish and nettles suffered by human beings and animals.
B~CKGROUND OF THE INVEN~ION
Much has been written and taught in the in~ustrial world about the treatment and healing of thermal and chemical skin burns suffered by human beings and animals.
The following United States patents disclose and claim substances which purportedly are useful in treating and healing burns:

United States Patent No. Inventor Issue Date 264,857 L.E. Bush September 26, 1882 4,291,062 S. Leigh et al. September 22, 1981 Bush discloses a composition for the treatment of burns comprising sassafras-root, pure olive oil, water of ammonia, crude petroleum and castor oil.
Leigh et al. discloses pharmaceutical compo-sitions for application topically or by suppository comprising (a) a medicament, preferably protected rom degradation by moisture by being presented in small particles of a waxy material, (b) from 5% to 40% of an inclusion compound of urea with a straight-chain aliphatic compound, preferably a fatty acid or alcohol, ~c) up to 50~ of an inert insoluble powder such as ~

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starch, (d) from 25~ to 90% of an inert carrier, components (a), (b) and (c) being dispersed in (d).
The science of burn therapy has advanced considerably in recent times. It is commonly r~cognized that burn treatment should commence without delay, involving cooling of the burned area and keeping it clean. Notwithstanding, there are still a number of long-standing and even relatively recently developed misconceptions and ingrained practices regarding burn treatment and therapy. Not all of these practices necessarily represent optimum burn therapy. One common practice which may be ac-tually retrogressive to the treatment of a burn is simply to put salves, or the like, on a burn and let the burn progress into an advanced stage, possibly a higher degree, before prescribing other treatmentO
A frequent switch in the method of burn treatment indicates that no effective primary treatment is yet being employed. Initial treatment prescribed by a physician or a hospita~ burn unit for a burn victim is usually "symptomatic" and directed to preventing or relieving shock in the victim, relieving pain, caring for the wound, controlling infection, correcting atten-dant anemia, observing strict asepsis and maintaining nutrition. Common practice at burn centres today is to treat badly burned patients with massive transfusions of electrolytes, colloids (plasma and albumin) and water to prevent or relieve hypovolemic shock, and then to bathe the burn daily as soon as initial shock phase ends. The initial shock phase may last up to three days and could ~7~

delay treatment. The bathing medium is ordinary tap water, and not a saline solution as has been customary in the past. After the bath, a topical antibiotic such as silver sulphadiazine, gentamycin or povidone-iodine is applied to the wound, and left exposed. The most common complication and cause of death in burn victims is infection. Preventing infection is an important part of the treatment.
Skin grafting is often prescribed as a means of reducing disfiguration from burns. Jobst garments (enveloping pressure yarments) are widely used and are put on the patient as soon as the grafted skin has healed. The pressure applied apparently helps to prevent scarring and keloid formationr and promotes better healing.
The estimated average length of hospital stay of a burn victim in North America is fourteen days, based on Vital Statistics published by the United States and Canadian governments~ First degree burns are stated by the Vancouver General Hospital as healing usually within lO days. Second and third degree burns take much longer. Third degree burns are often followed by skin grafting.
The techniques of burn -therapy are under continuous review and active research is taking place in the following areas.
l. Diet. It has been found that it is important that the maximum calorie dosage required is available to each patient.

2. Measures to decrease the depth of injury at the time a burn occurs, such as prompt cooling and first aid on the spot.

3. Factors to improve blood circulation, such as drugs, cooling, hyperbaric oxygen and prevention of drying out of the skin using barrier membranes~

4. Growing sheets of human skin in a labora-tory from a few skin cells, and using this artificially produced skin for skin grafting.

5. Identification of factors which produce hypotrophic scars and keloids.

6. Shortening the healing and grafting process. Investigations underway include prostaglandin inhibitors, barrier membranes and drugs that prevent blood coagulation and vascular bed contractionO
Considering the common burn treatment practices indicated above, it becomes apparent that there is a need for an effective early method of treat-ment which arrests the progression of the burn with its complications, thus reducing the substantial time and material efforts expended at burn treatment centres.
Such a method would have important first aid implica-tions.
SUMMARY OF THE INVENTION
~e have developed a novel composition which we have discovered is very useful in the treatment and healing of thermal, chemical and ultraviolet skin burns, in frost bite, and in treating skin irritants such as insect bites, and stings of jelly-Eish and nettles. The composition surprisingly includes an ammonium containing ~'7~

substance which has a disagreeable odour and has been sug~ested as beinc~ toxic in biochemical studies relating to burns.
The invention is direc-ted to a compo~ition whîch is useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and sXin irritants such as insect bites and stings from jellyfish and ne-ttles, comprising: (a) a compound selected from the group consistiny of ammonium carbonate, ammonium caLbamate and a~nonium bicarbonate; and (b) a sui-table burn innocuous carrier, The inven-tion in one aspect is directed to a compositioll which is use~ul in the treatment of thermal, chemical and ultraviolet ~urns, rost bites, and skin irritants, such as insect bites and stings from jelly-fish and nettles, comprising: (a) one part by weight of a compound selected rom the group consisting of arrunonium carbonate, ammonium carbamate and ammonium bicarbonate; (b) urea (0 to 10 percent by weight o~
element (a)); (c) a suitable arnount of an innocuous ammorlia aroma maskinc3 agent; ~nd (d) five to twenty p~lrts by welght wa-ter.
r~'he invention in another aspect is directed to ~r~ ~ composition useEul in the treatrnent of t}ermal, chemi-cal and ultraviolet burns comprising: (a) one part by weight amrt1onium carbonate, and (b) five to twenty parts by weight wa-ter. In the compositiorl, the water may he kep~ sep~rate from element (a) and may be Ini~e~ with ~ ele~ment (a) immecli--tely p~:ior: to applicatioll to the burn ~:~g7~

wound. In the composition, ammonium carbamate and ammonium bicarbonate may be present with the ammonium carbonate in ambient equilibrium. In the composition, the ammonium carbonate complex may be ahout 10 percent by weight of the total solution.
DETAILED DESCRIPTION OF THE INVENTION
The composition described in the previous paragraph contains what are believed to be the key ingredients for the burn therapy composition. A more complex composition comprises:
1. an equilibrium combination of ammonium carbonate ((NH4)2C03), ammonium carbamate (NH4C02NH2); and ammonium bicarbonate (NH4HC03), 2. Urea ((NH2)2CO), 3. Balsam; and, 4. ~ater as carrier.
This composition has been developed and successEully used in treating first to third degree ~ burns on humans.

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As a result of tests on animals and treatment of more than 500 burn patients using various proportions of the ammonium compounds ~ammonium carbonate, carbamate and bicarbonate), and urea, and various concentrations in aqueous solutions, it has become apparent that a preferred solution of the burn treatment composition is a mixture of:
(1) Ammonium carbonate/ammonium carbama~e/
ammonium bicarbonate in equilibrium, which is 10ideally shifted away from the ammonium bicarbonate component;
(2) Urea up to 1/10 by weight of ingredient (1);
(3~ Balsam (a very small quantity sufficient to mask the ammonium odor); and 15(4) H2O (cold drinking water is appropriate but distilled water is also suitable).
In practice, ingredients (1), (2) and (3) can be combined into one component (component A) while ingredient (4), water, is kept as a separate component (component B). Preferably about one part of Component A
should be mixed with about nine parts of component B.
Empirical results indicate that the ammonium carbonate-carbamate component is more effective -than ammonium bicarbonate in burn treatment. Therefore, for best results, whenever possible, an attempt should be made to minimize the bicarbonate proportion. One way to do this is to ensure the ammonium complex is fresh and has not been exposed to air for a lengthy period because that encourages mainly the build up of the bicarbonate proportion.

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When required for the treatment of a burn, the composition is prepared by mixing component A with component ~ (which yields approximately a 1~ solution), as soon as possible, following the burn insult. In solution, the composition undergoes ionization, which is apparently useful in the detoxification of the burn wound. Component A, as it dissolves in component B, undergoes an endothermic reaction, thereby causing a therapeutic cooling effect on the burn wound if applied immediately. The temperature drop can be as much as 10C. It is important that the burn wound not be cooled unduly because that may retard blood circulation and the healing process.
A specific method of treating the burn wound with the topical burn composition should be followed.
This method is described in the case studies which are presented later in this disclosure. Typically, a 10% by weight solution is applied to the entire burn area as soon as possible after insult. The burn is continuously bathed or rinsed with this solution, keeping it in circulation relative to the burned areaO If the burn is over a small area and not too severe, the total bathing time may be less than one hour in order to achieve mean-ingful results. In more severe cases (second and third degree burns over large areas), 5% by weight solution is initially applied for 10 minutes, followed by a 10% by weight solution; the required bathing period may be 2 to 3 hours. The bathing time required is usually governed by the severity of the burn and the time elapsed between burn insult and commencement of bath. The time required in each case is indicated by achieving permanent pain reliefO The burn victim will usually call Eor the bath to be continued if pain returns. In the event that pain returns during a prolonged bathing session, the need for a freshly prepared solution may be indicated~ In severe burn cases where any one or more of the following is applicable, (1) time elapsed from burn insult to com-mencing treatment has been excessive, (2) deep burns have been suffered, (3) pressure has been exerted on the burned area after the bath, or (~) only partially de-graded rather than fresh ammonium carbonate complex was available for treatment, repeated baths up to 3 hours duration, every day or every second day, may be advis-able. It is important for maximum results to maintain continuous circulation of the solution over the entire extent of the burned area. Blisters and dead skin fragments should ~e removed before bathing is started to assume full effect of the treatment composition. Any undua pressure exerted on the burned area is to be ~0 avoided because that may trigger new burn symptoms, calling for additional bathing sessions. After the bath, the wound may be protected by a light dressingO
While we do not wish to be adversely bound by any theories, it may be helpful for purposes of dis-closing and understanding the invention to discusscertain theories and impressions we have formed about the therapeutic mechanisms of the burn treatment compo-sition we have invented. It is suspected that the presence in the composition of the ammonium radical (which has been regarded by at least one source as being toxic in biochemical studies relating to burns~ has l~g7~

surprising beneficial properties in the treatment of burns. The ammonium radical appears to be active in neutralizing suspected harmful toxins that are generated by a burn insult, neutralizing the acids which are generated after burn insult, acting as a sterilant, contributing a rehabilitating effect on the nerves damaged by the burn (following an initial sharp sense of pain phase which lasts for about 30 seconds), arresting progression of the burn damage, and discouraging swel-ling, and retarding the burn from oozing fluids withattendant harmful dehydration. A curious unexplained characteristic of the burn treatment composition is that once the initial pain peak, which is experienced follow~
ing the first time of application, is passed and the soothing phase is reached, pain will again be felt if the solution is prematurely removed. This is thus a useful indicator of the state and effect of treatment.
~ t is also possible that there is a syner-gistic effect between the ammonium component and the urea. The therapeutic qualities of the treatment are enhanced by moving the burn wound through the solution (such as in a bath), or by circulating the solu-tion on the burn wound.
The balsam component is not essential to the burn treatment compositionO It is included to act as a mild, non-burn aggravating, masking agent for the slight offensive ammonia smell which is generated when the ammonium compound is dissolved in water. Any other suitable innocuous ammonia masking agent may be used in place of the balsam.

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It is expected that the burn composition will be distributed in the marketplace as a two component package (component A and component B in prescribed proportions ready for mixing when needed). As an alternative to the water component (component B) being ~istribu~eA in company with component A, component A can be sold or distributed separately, or water available at -the treatment site (eg., tap water) can be used. In that case, some care will be needed to provide a solu tion where component A is approximately 5 to 15~ by weight of the total solution in order to provide maximum therapy benefit. The ammonium component can also be used in granular form without the presence of balsam, if a slight ammonium smell is not considered a disadvantage.
Since it is preferable that the ammonium component be fresh in order to have its greatest bene-fit, it is important that Component A is well-sealed so that it cannot be degraded by the atmosphere. The use of dark or ultra violet resistant containers is there-fore recommended.
It is proposed to market the new burn treat-ment composition under the trade mark BRANDFORT (abbre-viated BF in the case studies which follow).
~5 In addition to being useful as a treatment for thermal, chemical and ultraviolet (sun) burns, the composition described is useful as a topical first aid treatment for frost bite, skin irritants such as insect bites, jellyfish stings and nettle stings.

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The composition, when applied as soon as possible to a burn wound, is believed to have the following beneficial burn therapeutic mechanisms:
(a) It arrests the progression of the burn damaye and thereby limits the depth of the burn (skin necrosis) (b) After an initial short pain peak, it rapidly eliminates pain (possibly by the reduction of edema).
(c) It controls infection by encouraging the formation of vellum ~drying of the wound surface), and because it has antibacterial, and inflammation prevention qualities.
(d) It controls water loss from the burn. It appears to discourage increased metabolism and negative protein balance, and is a hydrating agent.
(e) A freshly prepared solution is endo-thermic in character and thus has a beneficial cooling effect on the burn wound when applied immediatel~.
(f) It restores pH balance in the burned area.
(g) It has deep burn penetration qualities.
(h) It appears to have a detoxification effect on suspected toxic burn products which are believed to be harmful to the burn healing process.
(i) It minimizes scar formation and healing time.

Description of Experiments Conducted with Burn Victims Case #l 1. Study No.: 021 2. Sex: Male 3. Age: 60 4. Occupation: Foundry worker 5. Location of Accident: Home 6. Cause of Burn: Explosion of cigarette lighter;
left hand engulfed in burning naptha

7. Type of Burn: Flame heat 80 Physician: H. Haas 9. Practice: Private 10. Site of Burn: Left hand 11. Degree: 2-3 12. Extent of Burn: 300 cm2 13. Condition of Burn Surface: Charred skin, skin fragments hanging from three fingers, blisters under formation 14. General Condition of Patient before Treatment:
Strong pain 15. Pre Treatment (BF Unrelated): Flour, fat 16. Pre Treatment (BF Related): None 17. Time Elapsed Without Treatment: 15 minO
13. Duration of BF Bath: 120 min.
19. Form of BF: Bath~ fresh preparation 10%; "ammonium bicarbonate and urea"
20. Method o BF Administration: Dip bath 21. Administration of Other Medicine: None 22. Number o Applications: 1 session 23. Total Duration of BF Application: 120 min.

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24. Reaction of Patient During Bath: None recorded 25~ Complications: None 26. Time Elapsed to Permanent Pain Relief. 1~0 min.
27. Initial Results, Condition of Wound After Bath:
Redness disappeared, slight yellow tint, blisters regressed, parchmenti~ation 23. General Condition of Patient After Bath: No pain 29. After Treatment: Aristamid* gel, cellulose dressing 30. Healing Course: Without disturbance 31. Total Healing Time: 6 days, shedding of parchment skin (not recorded) 32. Condition of Healed Wound: No scar, full epitheli~ation 33. Condition of Patient After Treatment: Normal 34. Complications: None 35. Judgement of Overall Treatment/Healing: Successful 36. Comment: It is believed that the application ~f gel delayed the healing time by 1-2 ~ays.
Case #2 1. Study No.: 001 2. Sex: Male 3~ Age: 2 ~. Occupation: N/A, infant 5. Location of Accident: Home 6. Cause of Burn: Wedging between red glowing oven and wall 7. Type of Burn: Dry heat æ. Physician: K. Ahlborn 9. Practice: Private * Trade Mark 10. Site of Burn: Left temple, left ear, cheelc 11. Degree: 2-3 12. Extent of Burn: 100 cm2 13. Condition of Burn Surface: Open, strongly oozing, partly debrided, blisters, scorched 14. General Condition of Patient beore BF Treatment:
Very strong evident pain; child cried until "blue"
15. Pre Treatment (BF Unrelated): None 16. Pre Treatment (BF Related): None 17. Time Elapsed Without BF Treatment: 15 min.
18. Duration of BF Bath: 150 min.
19. Form of BF: Bath, ready supply solution; 5 min.
with 5~ solution; then 10% solution; "ammonium carbonate"
20. Method of BF Administration: Soaked cotton compresses 21. Administration of Other Medicine: None 22. Number of Applications: 1 session 23. Total Duration of BF Application: 150 min.
24. Reaction of Patient During Bath: Instant pain relief 25. Complications: None observed 26. Time Elapsed to Permanent Pain Relief: 150 min.
27. Initial Results, Condition of Wound After Bath:
Normal color, parchmentization, no inflammation 28. General Condition of Patient After BF Bath: No pain 29. After Treatment: Fissan* powder, dry dressing, protection against pressure by cellulose cushion 30. Healing Course: Without disturbance * Trade Mark :~97~

31. Total Healing Time: 7 days, shedding of parchment skin 32. Condition of Healed Wound: No scars, full epithelization, no inflammation 33. Condition of Patient After Treatment: Normal 34. Complications: None 35. Judgement of Overall Treatment/Healing: Successful 36. Comment: None Case #3 1. Study No.: 005 Sex: Male 3. Age: 2 4. Occupation: N/A, infant 5. Location of Accident- Home 6. Cause of Burn: Sitting down into boiling hot water 7. Type of Burn: Wet heat

8. Physician: A. Stampa

9. Practice: Private

10. Site of Burn: Abdomen, upper half of thighs, buttocks, genitals

11. Degree: 2-3

12. Extent of Burn: 1000 cm2

13. Condition of Burn Surface: Fire red, oo~ing, blisters everywhere

14. General Condition of Patient before BF Treatment:
Very strong evident pain

15. Pre Treatment (BF Unrelated): None

16. Pre Treatment (BF Related)- None

17. Time Elapsed Without BF Treatment: 10 min.

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18. Duration of BF Bath: 120 min.

19. Form of BF: Bath, ready solution, 10~; "ammonium carbonate"

20. Method oE BE Administration: BF soaked compresses, continual flooding

21. Administration of Other Medicine: None

22. Number of Applications: 1 session

23. Total Duration of BF Application: 120 min.

24. Reaction of Patient During Bath: None recorded

25. Complications: None recorded

26. Time Elapsed to Permanent Pain Relief: 120 min.

27. Initial Results, Condition of Wound After Bath:
Not recorded

28. General Condition o Patient After Bath: Complete pain relief

29. After Treatment: None necessary

30. Healing Course: Without disturbance

31. Effective Healing Time: 2 hours tSkin granulation is not included in time frame recorded - presumably 1 week)

32. Condition of Healed Wound: Normaliged

33. Condition of Patient After Treatment: Normal

34. Complications: None; no scars

35. Judgement of Overall Treatment/Healing: Full success

36. Comment: None Case #~
1. Study No.: 036 2. Sex: Female 3. Age: 50 -~97 1~

4. Occupation: Housewife 5. Location of Accident: Home 6. Cause of Burn: Contact with boiling fat 7. Type of Burn: Wet heat 8O Physician: K. Ahlborn 9. Practice: Private 10. Site of Burn: Entire right hand 11. Degree: 2-3 12. Extent of Burn: 300 cm2 13. Condition of Burn Surface: Wound cpen, debrided, fried, fire red, strong edema over all of hand, beyond blister stage 14. General Condition of Patient before BF Treatment:
Flaming pain 15. Pre Treatment (BF Unrelated): None 16. Pre Treatment (BF Related): None 17. Time Elapsed Without BF Treatment: 20 min.
18. Duration of BF Bath: 90 min.
19. Form of BF: Fresh preparation, first 5 min. 5%, 10~ following; "ammonium bicarbonate and urea' 20. Method of BF Administration: Alternating dip baths, (1) bath - BF, (2) bath - flowing cooling water 21. Administration of Other Medicine: None 22. Number of Applications: 1 session 23. Total Duration of BF Application: 90 min.
24. Reaction of Patient During BathO Not recorded 25. Complications: None 26. Time Elapsed to Permanent Pain Relief: 90 min.

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27. Ini~ial Results, Condition of Wound After Bath:
Wound free of pain, normal skin co]or except for 10 cm2 with deep loss of substance, full parchmentization, secretion stopped 28. General Condition of Patient After Bath: No pain 29. After Treatment: Dry dressing with Fissan* powder 30. Healing Course: Smooth, quick, no complications, no disturbance 31. Total Healing Time: 390 cm2 new epithelization in 3 days; rest 10 cm2 healed after 7 days;
patient lost 3 working days 32. Condition of Healed Wound: Normal, no abscess, no scars 33. Condition of Patient After Treatment: Normal 34. Complications: None 35. Judgement of Overall Treatment/Healing: Success 36. Comment: None Case #5 1. Study No.: 029 2. Sex: Female 3. Age: 60 4. Occupation: Housawife 5. Location of Accident: Home 6. Cause of Burn: Contact with boiling soap water 7. Type of Burn: Wet heat 8. Physician: K. Ahlborn 9. Practice: Private 10. Site oE Burn: Right shin, ankle, dorsum of foot 11. Degree: 2 12. Extent of Burn: 300 cm2 * Trade Mark 71~

13. Condition of Burn Sur~ace: Fiery red, three debrided locations, blister formation 14. General Condition of Patient before BF Treatment:
Intense pain 15. Pre Treatment (BE Unrelated): None 16. Pre Treatment (BF Related): None 17. Time Elapsed Without BF Treatment: 10 min.
18. Duration of BF Bath: 180 min.
19. Form of BFo Bath fresh preparation; first 5%, then 10~; "ammonium bicarbonate and ureal' 20. Method of BF Administration: Rinsiny and dip bath 21. Administration of Other Medicine: None 22. Number of Applications: 1 session 23. Total Duration of BF Application: 180 min.
24. Reaction of Patient During Bath: None recorded 25. Complications: None 26. Time Elapsed to Permanent Pain Relief: 180 min.
27. Initial Results, Condition of Wound After Bath:
Normal skin color, three small oozing areas where deep tissue loss 28. General Condition of Patient After Bath: No pain 29. After Treatment: Fissan* powder, dressing on oozing spots 30, Healing Course: Short and thorough without disturbance 31. Total Healing Time: Not recorded; patient lost lf2 working day 32. Condition o Healed Wound: Skin fully regenerated 33. Condition of Patient After Treatment: No pain 3~. Complications: None * Trade Mark 7~

35. Judgement of Overall Treatmen~/Healing: Healing results very good 36~ CommentO None Case #6 1. Study No.: 008 2. Sex: Male 3. Age: 22 4. Occupation: Construction worker 5. Location of Accident: Outdoors 6. Cause of Burn: Wood preservative vapours and splashes, together with sun radiation 7. Type of Burn: Chemical, dry heat 8. Physician: K. Ahlborn 9. Practice: Private 10. Site of Burn: Face, neck, chest, arms 11. Degree: 1-2 12. Extent of Burn: 400U cm2 13. Condition of Burn Surface: Fiery red skin, with many burst blisters 14. General Condi-tion of Patient before BF Treatment:
Agonizing burning pain 15. Pre Treatment (BF Unrelated): Cold water, cool air during bicycle ride - no lasting improvement 16. Pre Treatment (BF Related): None 17. Time ~lapsed Without BF Treatment: 60 min.
18. Duration of BF Bath: 90 min.
19. Form of BF: Bath, ready solution, 10%; feedstock, "ammonium carbonate"
20. Method of BF Administration: BF soaked compresses, rinsing ~7 ~

21. Administration of Other Medicine~ None 22. Number of Applications: 1 session 23. Total Duration o~ BF Application: 90 min.
24~ Reaction of Patient During Bath: None record0d 25. Complications: None 26. Time Elapsed to Permanent Pain Relief: 90 minO
27. Initial Results, Condi-tion o Wound After ~ath:
Redness disappeared, blisters regressed 28. General Condition of Patient After Bath: No pain 29. After Treatment: Fissan* powder, bed rest (1 night) 30. Healing Course: Without disturbance 31. Total Healing Time: 17 hours; patient lost 1/2 working day 32. Condition of Healed Wound: No scars 33. Condition of Patient After Treatment: No pain 34. Complications: None 35. Judgement of Overall Treatment/Healing: Healing results very good 360 Comment: Wood preservative: Karbolineum*
Case #7 1. Study No.: 010 2. Sex: Female 3. Age: 18 4. Occupation: Laundry helper 5. Location of Accident: Laundry room 6. Cause of Burn: Fell and spilled concentrated Lysol*
7. Type of Burn: Chemical 8. Physician: K. Ahlborn * Trade Mark ~97:~9~

9. Practice: Private 10. Site of Burn: Forearm, left wrist 11. Degree: 3 12. Extent of Burn: 300 cm2 13. Condition of Burn Surface: Red brown, cauterized, skin fiery red at margins of burned area 14. General Condition of Patient before BF Treatment:
Unbearable pain 15. Pre Treatment (BF Unrelated): Rinsing with cold water 3 min. after insult lÇ. Pre Treatment (BF Related): None 17. Time Elapsed Without BF Treatment: 5 minO
18. Duration of BF Bath- 300 min.
19. Form of BF: Bath ready supply solution, 10~;
"ammonium carbonate"
20. Method of BF Administration: Dip bath 21. Administration of Other Medicine: None 22. Number of Applications: 2 sessions, (2nd session 3 hours commencing 4 hours after termination of 1st session) 23. Total Duration of BF Application: 8 hours 24. Reaction of Patient During Bath: Reduced pain 25. Complications: None 26. Time Elapsed to Permanent Pain Relief: 12 hours 27. Initial Results, Condition of Wound After Bath:
Redness disappeared. After second treatment, cauterized area was leathery chocolate brown~
28. General Condition of Patient After Bath- Pain returned 4 hours after termination of first bathing session, disappeared after second bath 29. After Treatment: Fissan* powder, soft dressing 30. Healing Course: Not recorded 31. Total Healing Time: 1-1/2 days, 7 days to shed leathery (crusted) skin 31. Condltion of Healed Wound: No scars 32. Condition o Patient After Treatment: No pain 33. Complications: None 35. Judgement of Overall Treatment/Healing: Good healing results 26. Comment: Quality of "ready supply solution" used in this case may have been inferior Case #8 1. Study No.: 031 2. Sex: Male 3. Age: 3 4. Occupation: N/A, infant 5. Location of Accident: Elome 6. Cause of Burn: Contact with boiling soapy water 7. Type of Burn: Wet heat 80 Physician: Ernst Weidlich 9. Practice: Private 10. Site of Burn: Abdomen, upper thighs, buttocks, penis, scrotum 11. Degree: 2 12. Extent of Burn: Approximately 800 cm2 13. Condition of Burn Surface: Strong reddening, swelling, bloated blisters 14. General Condition o~ Patient before BF Treatment:
Extreme evident pain 15. Pre Treatment (BF Unrelated): None * Trade Mark 19~
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16. Pre Treatment (BF Related): Removal of skin from blisters 17. Time Elapsed Without BF Treatment: 30 min.
18. Duration of BF Bath: 3 hours 19. Form of BF: Standard, 10%; "ammonium bicarbonate and urea"
20. Method of BF Administration: Rinsing, bath 21. Administration of Other Medicine: None 22. Number of Applications- 7 sessions 1. Session 1, day 1 - 3 hours (no pain, parchmentization, dry wound, clean) 2. Session 2, day 3 - 15 min. (no pain, normal color, bloated blisters/removed) 3. Session 3, day 5 - 15 min. (heavy pain, due to pressure caused by weight of reclining patient) 4. Session 4, day 7 - 15 min.
Fifth to seventh sessions - Total 30 min.
23~ Total Duration of BF Application: 4 hours, 15 min.
24. Reaction of Patient During Bath: Not recorded 25. Complications: Other than indicated above, none recorded 26. ~ime Elapsed to Permanent Pain Relief: Pain recurred on and off after 3 days for 3 days 5 27. Initial Results, Condition of Wound After Bath~
Full parchmentization 28. General Condition of Patient After Bath: After 1 session, no pain; later pain due to pressure by body weight 29, After Treatment: Sterosan* powder * Trade Mark 30. Healing Course: Pain recurred due to body weight pressure; healing prolonged in location subjected to pressure (buttocks) 31. Total Healing Time: 3-1/2 weeks 32. Condition of Healed Wound: Surficial, minor scars on buttocks 33. Condition of Patient After Treatment: Normal 34. Complications: Besides small scars, none 35. Judgement of Overall Treatment/Healing: Healing time somewhat delayed due to pressure on burned area caused by weight of body, leaving minor weak scars on buttocks 36. Comment: It is believed that "ammonium carbonate"
would have been more effective.
Case #9 1. Study No.: 009 2. Sex: Female 3. Age: 30 4. Occupation: Housewife 5. Location of Accident: Home, laundry room 6. Cause of Burn: Boiling soapy water 7. Type of Burn: Wet heat 8. Physician: K. ~hlborn 9. Practice: Private 10. Site of Burn: Whole face, eye lids 11. Degree: 2-3 12. Extent of Burn: 400 cm2 13. Condition of Burn Surface: Swollen, oozing, extensive blisters 1 ~97~

14. General Condition of Patient beEore BF Treatment:
Unbearable pain (patient screaming) 15. Pre Treatment (BF Unrelated): Cold water 16. Pre Treatment (BF Related): None 17. Time Elapsed Without BF Treatment: 15 min.
18. Duration of BF Bath: 90 min~
19. Form of B~: Bath, preparation of fresh solution, 5 min. with 5% solution, 85 min. with 10~ solution;
"ammonium carbonate"
20. Method of BF Administration: BF soaked compresses 21. Administration of Other Medicine: None 22. Number of Applications: 1 session 23. Total Duration of BF Application: 90 min.
2~. Reaction of Patient During Batho None recorded 25. Complications: None 26. Time Elapsed to Permanent Pain Relief: 90 min.
27. Initial Results, Condition of Wound After Bath:
Skin yellowish tinted crusting, dry, blisters regressed 28. General Condition of Patient After Bath: No pain 29. After Treatment: Open to air 30. Healing Course: Excellent 31. Total Healing Time: 6 days to shed yellow parchment skin 32. Condition of Healed Wound: No scar formation 33. Condition of Patient After Treatment: Excellent 3~. Complications: None 35. Judgement of Overall Treatment/Healing: Excellent 36. Comment: N/A

~7~

Case #10 1. Study No.: 012 2. Sex: Male 3. Age: 28 4. Occupation: Soldier 5. Location of Accident: Outdoors 6. Cause of Burn: Gasoline explosion 7. Type of Burn: heat, explosion 8. Physician: K. Ahlborn 9~ Practice: Field hospital 10. Site of Burn: Face, neck, chest, abdomen, inside of arms and thighs 11. Degree: 2-3 12. ~xtent of Burn: 6000 cm2 13. Condition of Burn Surface: Complicated tear burn, extensive areas deskinned, burst blisters, scorched, boiled skin, 5 impacts of explosion splinters, with deep holes in skin (2~3 cm in diameter) 14. General Condition of Patient before Treatment:
Very strong pain, later subdued, deep-dull, patient dizzy 15. Pre Treatment (BF Unrelated): Morphium, cod liver oil, ointment, compresses, bandage 16. Pre Treatment (BF Related)- Cleaning of wound of foreign substances with rubbing alcohol; removal of loose skin and blisters 17. Time Elapsed Without BF Treatment: 8 hours 18. Duration of BF Bath: 1~5 min~

19. Form of BF: Bath, 10 min. with 5~ solution; 135 min. with 10~ solution; "ammonium carbonatel' 20. Method of BF Administration: BF soaked compresses, later continuous rinsing of total burned area 21. Administration of Other Medicine: none 22. Nwnber of Applications: 1 session 23. Total Duration of BF Applica-tion: 145 min.
24. Reaction of Patient During Bath: Short resurgence oE pain (1 min.) until entire burned area was wettened with BF solution 25. Complications: Chills 26. Time Elapsed to Permanent Pain Relief: 145 min.
27. Initial Results, Condition of Wound After Bath:
Redness disappeared, dry wound, parchmentization, only impact wounds still sightly oozing 28. General Condition of Patient After Bath: Patient fully awake, pain disappeared 29. After Treatment: Fissan* powder, dry protective dressing 0 30. Healing Course: Without disturbance over following 24 hours 31. Total Healing Time: Not known, departed on train 32. Condition of Healed Wound: Not known, after 24 hours following bath, entire wound dry 5 33. Condition of Patient After Treatment: During observation time of 24 hours~ free of pain 34. Complications: None observed during observation time * Trade Mark 1~...~7.~

35. Judgement of Overall Treatment/Healing: Primary healing results encouraging 36. Comment: The severe large scale burn responded positively to BF treatment. Remarkable healing trend justified transportation.
These case studies clearly demonstrate the value of Brandfort ~BF) as an early efective treatment for burns, eliminating and/or minimizing complications such as infection and scarring, suffering of pain, and promoting healing and reducing the healing time.
As will be apparent to those skilled in the art in the light of the foregoing disclosure, many alterations and modifications are possible in the practice of this invention without departing from the spirit or scope thereof. Accordingly, the scope of the invention is to be construed in accordance with the substance defined by the following claims.

Claims (25)

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants such as insect bites and stings from jellyfish and nettles, comprising:
(a) a compound selected from the group consisting of ammonium carbonate, ammonium carbamate and ammonium bicarbonate; and (b) A suitable burn innocuous carrier.

2. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants such as insect bites and stings from jellyfish and nettles, comprising:
(a) Ammonium carbonate; and (b) A suitable burn innocuous carrier.

3. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants such as insect bites and stings from jellyfish and nettles, comprising:
(a) One part by weight ammonium carbonate, and (b) Five to twenty parts by weight water.

4. A composition as defined in Claim 3 wherein the water is kept separate from element (a) and is mixed - Page 1 of Claims -with element (a) immediately prior to application to -the burn wound.

5. A composition as defined in Claim 1 wherein the compound is a mixture of ammonium carbamate and ammonium bicarbonate.

6. A composition as defined in Claim 1 wherein ammonium carbamate and ammonium bicarbonate are present with the ammonium carbonate in ambient equilibrium.

7. A composition as defined in Claim 2, 3 or 4 wherein the ammonium carbonate represents about 5-15 percent by weight of the total mixture.

8. A composition as defined in Claim 2, 3 or 4 wherein the ammonium carbonate represents about 10 percent by weight of the total mixture.

9, A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants, such as insect bites and stings from jellyfish and nettles, comprising:
(a) One part by weight of a compound selected from the group consisting of ammonium carbonate, ammonium carbamate and ammonium bicarbonate, (b) urea (O to 10 percent by weight of element (a));

- Page 2 of Claims -(c) a suitable amount of an innocuous ammonia aroma masking agent; and (d) Five to twenty parts by weight water.

10. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants, such as insect bites and stings from jellyfish and nettles, comprising:
(a) One part by weight ammonium carbonate;
(b) urea (0 to 10 percent by weight of element (a));
(c) a suitable amount of an innocuous ammonia aroma masking agent; and (d) Five to twenty parts by weight water.

11. A composition as defined in Claim 10 wherein the water is kept separate from elements (a), (b) and (c) and is mixed with elements (a), (b) and (c) immediately prior to application to a burn site.

12. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbonate, ammonium carbamate and ammonium bicarbonate in ambient equilibrium.

13. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbamate and ammonium bicarbonate.

- Page 3 of Claims -

14. A composition as defined in Claim 9, 10 or 11 wherein the masking agent is balsam.

15. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbonate, ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about 5-15 percent by weight of the total composition.

16. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbonate, ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about 5 percent by weight of the total composition.

17. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbonate, ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about 10 percent by weight of the total composition.

18. A composition as defined in Claim 9 wherein the compound (a) is a mixture of ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about 5-15 percent by weight of the total composition.

- Page 4 of Claims -

19. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about S percent by weight of the total composition.

20. A composition as defined in Claim 9 wherein compound (a) is a mixture of ammonium carbamate and ammonium bicarbonate in equilibrium and the equilibrium mixture and the urea represent about 10 percent by weight of the total composition.

21. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants such as insect bites and stings from jellyfish and nettles, comprising:
(a) Ammonium carbonate, ammonium carbamate and arnmonium bicarbonate; and (b) A suitable burn innocuous carrier.

22. A composition useful in the treatment of thermal, chemical and ultraviolet burns, frost bites, and skin irritants such as insect bites and stings from jellyfish and nettles, comprising:
(a) One part by weight ammonium carbonate, ammonium carbamate and amrnonium bicarbonate; and (b) Five to twenty parts by weight water.

- Page 5 of Claims -

23. A composition as defined in Claim 22 wherein the water is kept separate from element (a) and is mixed with element (a) immediately prior to application to the burn wound

24. A composition as defined in Claim 21, 22 or 23 wherein the ammonium carbonate represents about 5-15 percent by weight of the total mixture.

25. A composition as defined in Claim 21, 22 or 23 wherein the ammonium carbonate represents about 10 percent by weight of the total mixture.

- Page 6 of Claims -