The efficacy of Aloe vera, tea tree oil and saliva as first aid treatment for partial thickness burn injuries Leila Cuttle a, *, Margit Kempf a , Olena Kravchuk b , Narelle George c , Pei-Yun Liu a , Hong-En Chang a , Julie Mill a , Xue-Qing Wang a , Roy M. Kimble a a Royal Children’s Hospital Burns Research Group, University of Queensland, Department of Paediatrics and Child Health, Royal Children’s Hospital, Herston Road, Herston, Queensland 4029, Australia b University of Queensland, School of Land, Crop and Food Science, St Lucia, Queensland 4072, Australia c Division of Microbiology, Pathology Queensland, Herston Hospitals Complex, Herston, Queensland 4029, Australia 1. Introduction First aid is emergency care or treatment given before regular medical aid can be obtained. In the case of a burn, it should provide analgesia and ideally halt the progression of injury. A prospective audit of 341 new burn patients who presented to the Stuart Pegg Pediatric Burns Centre at the Brisbane Royal Children’s Hospital in 2005 (data not shown) identified a number of alternative treatments applied by the public for the first aid treatment of burns. Although approximately 72% of people did use cold or ice water as first aid for burns, there were still a considerable number who used alternative therapies such as Aloe vera or tea tree oil products. Approximately 13% of patients had a Burnaid 1 dressing (a tea tree oil impregnated hydrogel dressing (sponge) developed by Rye Pharmaceuticals (Roseville, NSW, Australia)) applied as first aid for their burns, either alone or in conjunction with cold water. In most of these cases, the Burnaid 1 was applied by Queensland Ambulance on route to the hospital. Approxi- mately 2% of patients had Aloe vera applied as first aid for their burns, either alone or in conjunction with cold water. Although their use is widespread, alternative treatments usually have little evidence to support their use. There is one published study (with no statistical analysis) comparing Burnaid 1 to water cooling in a porcine model [1]. This study found that 15 8C compresses and Burnaid 1 reduced skin temperature and improved re-epithelialisation compared to control, although the 15 8C compresses were slightly better than Burnaid 1 . A recent review of four clinical trials investigating the effect of Aloe vera on burn wounds found that Aloe vera significantly shortened the wound healing time (by approximately eight days) compared to control. They concluded that it may be an effective treatment for first and second degree burns [2]. However, another study examining the effect of Aloe vera on gynecological wounds (wounds complicated by haematomas, seromas or abscess formation burns 34 (2008) 1176–1182 article info Article history: Accepted 24 March 2008 Keywords: First aid Alternative Aloe vera Saliva Burnaid Tea tree oil abstract Many alternative therapies are used as first aid treatment for burns, despite limited evidence supporting their use. In this study, Aloe vera, saliva and a tea tree oil impregnated dressing (Burnaid 1 ) were applied as first aid to a porcine deep dermal contact burn, compared to a control of nothing. After burn creation, the treatments were applied for 20 min and the wounds observed at weekly dressing changes for 6 weeks. Results showed that the alter- native treatments did significantly decrease subdermal temperature within the skin during the treatment period. However, they did not decrease the microflora or improve re-epithe- lialisation, scar strength, scar depth or cosmetic appearance of the scar and cannot be recommended for the first aid treatment of partial thickness burns. # 2008 Elsevier Ltd and ISBI. All rights reserved. * Corresponding author. Tel.: +61 7 3636 9067; fax: +61 7 3365 5455. E-mail address: L.Cuttle@uq.edu.au (L. Cuttle). available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/burns 0305-4179/$34.00 # 2008 Elsevier Ltd and ISBI. All rights reserved. doi:10.1016/j.burns.2008.03.012