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ScienceDirect

journal homepage: www.elsevier.com/locate/burns

The use of acupuncture in first aid of burns—Clinical

report

A. Loskotova a,b,c, * , J. Loskotova c,d

a
Medical Faculty of Masaryk University Brno, Czech Republic, Europe
b
3rd Medical Faculty Charles University, Department of Preventive Medicine, Prague, Czech republic
c
SALVE Centrum—Physiotherapy Clinic, Vysoké Mýto, Czech Republic
d
Faculty of Law—Dept. of Financial Law, Masaryk University, Brno, Czech Republic

article info abstract

Article history: Burns are a very painful skin injury, or injury of soft tissues. The development of post-
Accepted 25 April 2017 traumatic stress disorder can develop, even in those with minor injuries (Ia–IIb degree).
Available online xxx Development of problems is very rapid and intense since, according to developmental
embryology, the skin and central nervous system (CNS) descend from the same germ layer—
ectoderm.
Keywords:
This clinical report presents the results acquired from the data of 1008 patients suffering
Burn trauma (BT)
from burns treated by the acupuncture (ACU)—from 1983–2015 in the surgery ward of the
Post-traumatic stress (PTS)
hospital in Vysoke Myto in the Czech Republic.
First aid
The data of 1008 patients were processed and evaluated.
Acupuncture (ACU)
1. The report demonstrates a positive effect of ACU treatment signs on the skin were
Lung point 7 (LU 7)
monitored, i.e. reddening, pigmentation, scars. During the treatment the elimination of
Large intestine point 11 (LI 11)
many of these signs was observed.
Large intestine point 4 (LI 4)
Improvement of healing process and improvement in the final wound healing were
Wound healing
evaluated and shown by the statistical method—the x2 test. For demonstrating the effect of
Scar
ACU treatment of BT the Pearson's and the Cramer's contingency coefficient were examined.
2. The time of the first application of the ACU treatment after burn was followed and
evaluated with a random set. The best results were achieved when the first ACU treatment
was applied as soon as possible after BT injury (ideally immediately, optimally within 48h).
The positive effect of ACU on burns is medical, economical and biopsychosocial.
© 2017 Elsevier Ltd and ISBI. All rights reserved.

Scalding and burn burns from flame and chemicals, etc.

1. Introduction
Severe burn is defined as a condition which occurs by direct or
indirect action of supra-threshold value of thermal energy,
electricity, radiation or certain chemicals on the skin, soft
tissues or airways due to smoke inhalation [1].
lead to damage or destruction of skin at different depths.
The following factors are the most important: area, extent
and degree. Other factors also play a role: type of burns,
patient’s age, patient’s mental state and condition of their
immune system, and comprehensive medical history of the
patient.

* Corresponding author at: SALVE Centrum, Department of Physiotherapy, Jiraskova 177/IV, 566 01 Vysoké Mýto, Czech Republic, Europe.
Tel.: +420737753321.
E-mail address: LoskotovaAnna@seznam.cz (A. Loskotova).
http://dx.doi.org/10.1016/j.burns.2017.04.025
0305-4179/© 2017 Elsevier Ltd and ISBI. All rights reserved.

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2 burns xxx (2017) xxx –xxx

Burns are proportionally less represented than contusions
and severe bruising of the skin and soft tissues. But even with a
small range of scalding or burns the situation may dramati-
cally deteriorate with rapid development of a burn shock. If it is
not treated in time, the patient may even die. This type of
trauma is therefore ranked among the most serious injuries. In
Europe, burns are ranked 13th in the list of tragic events. The
sad fact is that 40% of all burn victims are children [2]. Globally,
burns are a serious public health problem. In the last 20 years,
the overall number of burn cases has risen due to a higher
number of transport accidents, international war conflicts and
also terrorist attacks. According to the World Health Organi-
sation, there are over 265,000 deaths each year from fires only,
with more deaths from scalds, electrical burns, and other
forms of burns for which global data are not available.
Burns are also characterized by increased pain intensity
and rapid development of post-traumatic stress. Development
of circulatory dynamic insufficiency in particular venous and
lymphatic systems and development of secondary inflamma-
tory response rapidly arise in many cases. Development of
hypertrophic scars is another complication in the context of
healing.
The important factors that affect prognosis of a burn
patient are proper first aid, provision of emergency care and
quick transport to a specialised institution [3,4]. The extent
and depth of the affected areas are directly proportional to the
length of exposure to heat (boiling liquids, burning or hot
objects) [4].
In standard burn care analgesics, sedatives, antibiotics,
frequent dressing changes, or also autotransplantation at deep
levels of injury (IIb–III) are encountered.
Most burn patients are fully conscious and well oriented and
try to cooperate. But it is always necessary to insure appropriate
first aid [5,6].
1.1. What is the reason for the use of ACU?
The author’s theory for explanation of the mechanism of
action of acupuncture in the acute phase of burn treatment is
mostly likely induction, a kind of repetition of previous
biological events on the virtual level. This model is represented
by a reflection of biological reality in an anti-idiotype network
inducing faster healing through interactions with the immune
system. This reaction would otherwise occur much later and in
more extensive lesions and associated with greater scarring
[7,8].
Needling affects the cerebrospinal fluid (CSF) concentra-
tions of naturally occurring opiate substances: dynorphin
(acting at spinal level), endorphin (acting within the brain) and
encephalin (acting both in the brain and on a spinal level).
Endorphins and encephalin are potent blockers that affect
pain arising from the musculoskeletal system. Dynorphinis a

Table 1 – Overview of active participation in Congresses in the period 1988–2013.

1988 ICMART Prague, CSSR First aid of acupuncture in burn trauma treatment
1996 ICMART Nicosia, Cyprus First aid of acupuncture in burn trauma treatment
1998 ICMART Miyazaki, Japan First aid of acupuncture in burn trauma treatment
1998 SA Recife, Brazil First aid of acupuncture in burn trauma treatment
1999 ICMART Riga, Latvia The use of acupuncture in complex therapy of burn trauma
2000 ICMART Vienna, Austria The use of acupuncture in complex therapy of burn trauma
2001 ICMART Berlin, Germany The use of acupuncture in complex therapy of burn trauma
2005 ICMART Prague, Czech Republic The use of acupuncture in complex therapy of burn trauma
2005 EXCO ICOM Daegu, Korea First aid acupuncture in the complex therapy of burn trauma
2006 ICMART Washington DC, USA First aid acupuncture in the complex therapy of burn trauma
Acupuncture and myofascial manual lymphatic drainage
2007 ICMART Barcelona, Spain Acupuncture, lymphatic system and dysfunction in traumatology in complex
therapy of burn trauma
Function changes in traumatology and their therapy—method “LOSANN”
2007 ICOM Taipei, Taiwan The use of acupuncture in complex therapy of burn trauma
2007 20th CA PietraNeamt, Romania Acupuncture and myofascial manual lymphatic drainage in complex therapy of
burn trauma
2008 ICMART Budapest, Hungary New methods in traumatology and their application in complex therapy of burn
(Award for 3rd place)
2008 ICMART Thessaloniki, Greece Functional changes in traumatology and their therapy (BT)
2010 World Congress of Zagreb, Croatia Legal, ethical and economic issues of complementary medicine in complex therapy
Medical Law of burn trauma
2010 18th ISSC Gdansk, Poland Legal and economic issues of CAM methods (Award for 3rd place in surgery)
2010 SSHL Brno, Czech Republic Physician´s liability and parent´s right in treatment of minors (burn trauma cases)
2011 NATO Praha, Czech Republic Military Health care Working Group, 1st aid with application of complementary
standard in the frame of basic standard therapy
2013 9th Asia-Pacific Hanoi, Vietnam Burn trauma and first aid of acupuncture
Burn Congress
Burn trauma functional pathology of lymphatic system and soft tissues
2013 15th European Burn Vienna, Austria Burn trauma and first aid of acupuncture
Association Congress

Please cite this article in press as: A. Loskotova, J. Loskotova, The use of acupuncture in first aid of burns—Clinical report, Burns (2017),
http://dx.doi.org/10.1016/j.burns.2017.04.025
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powerful modulator of visceral pain; it has a weaker effect on
musculoskeletal pain modulation [9].
The depth of burns is an essential criterion for the selection
of surgical intervention or conservative procedures and is a
factor in the long-term prognosis of burn patients´ morbidity.
The other factors, in particular the elimination of post-
traumatic stress, affect the short-term prognosis.
1.2. History of the acupuncture in burn trauma treatment
The first brief note on the application of acupuncture in
sunstroke, with application of needles in the acute care unit,
Lung point 7, was mentioned by Lebarbier [10]. In the 1980s, in
Czechoslovakia, Karel Prusik, M.D. (general practitioner,
acupuncturist) applied acupuncture to a limited number of
patients with scalding, and noticed faster and better healing of
the skin. However, neither the method nor frequency of
application, nor the timing and duration of the action were
listed anywhere in the literature.Therefore in 1983 Mrs. Anna
Loskotova, M.D. began to carry out an empirical study, when
she applied acupuncture to all burn patients in the surgical
ward at the hospital in Vysoke Myto (Czech Republic, Europe).
Doctor Loskotova also monitored and documented all the
dressing changes and results of healing. First, she applied
acupuncture twice a day for at least 30min. In some serious
cases needles were left for several hours. In more severe
degrees of BT, the needles were applied directly in the
operating theatre. In some cases the needles were applied
directly on the spot of the injury. The patients were then
immediately transported to the specialized ward in the
hospital.
Mrs. Loskotova applied acupuncture to burn patients in the
following workplaces:
 1983–1993 Ward of Surgery, Hospital in Vysoke Myto, Czech
Republic.
 1993–2014 Clinic of Physiotherapy in Vysoke Myto, Czech
Republic.
 1990 (02–03) International course on acupuncture under the
leadership of Professor Nguyen-Tai Thu in Vietnam—
Hanoi, and within this period she gave a workshop on early
acupuncture in burn treatment in the Centre for burns Prof.
Le The Trung.
 2008 (10)–2014 (06) Experiences with burn patients within
post-graduate studies at the Clinic of Burns and Recon-
structive Surgery, University Hospital in Brno-Bohunice,
Czech Republic. The first results of her empirical experi-
ences were presented in various international congresses
from the year 1988. Presentation of experiences at
Congresses in the period 1988–2013 is given in Table 1.
2. Methodology
Our retrospective study is formed by our 33 years of empirical
experience with 1008 patients (since 1983). The injury in each
patient was documented by taking pictures at almost every
dressing change. All available burned patients were monitored
for 2–4 months, according to their clinical state. In the first few
years, acupuncture was delivered twice a day. During the
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http://dx.doi.org/10.1016/j.burns.2017.04.025
3
ongoing years, after getting empirical experiences, acupucture
was delivered once a day until complete wound healing.
3. Methods
According to the evolutionary embryology, the skin, lungs,
central nervous system and colon belong to the ectoderm.
Therefore, the application of needles into acupuncture active
points on these channels is potentially effective in acute
treatment of burns and skin healing.
3.1. Lung Point 7–LU 7 (called Lieque)
Point 7 of the Lung Channel is a point of LUO transition, an
output point of the lung meridian with conjunction to the
input point of the large intestine meridian. It has LI 4/analgesic
and immunostimulating effects.
A cardinal point of the meridian REN-MAI, or the Concep-
tion Vessel, Intake Channel, is thought to restore the
conjunction of lungs with kidneys and affects skin damage.
To localise point 7 of the Lung Channel, cross both “Tiger
Mouths” (folds between thumb and index fingers) vertically,
and the top of the index finger points at it (see Fig. 1).
Localisation: between tendons of brachioradialis and
abductor pollicis longus, it is in the radial edge of m. pronator
quadratus. In the surface layer, there are branches of radial
nerve and cephalic vein, and in the deeper layer branches of
the radial vein. Innervation is via the cutaneous brachior-
adialis and superficial radial nerve [11,12] (see Fig. 2).
In case of the difficult access to the point LU 7 (severe burn
degree, etc.) point LI 11 is used instead.
3.2. Large Intestine Channel point—LI 11 (called Quchi)
LI 11 is thought to be an important acupuncture point in
treatment of fever, and also LU 7 and BL 40 are used in cases of
skin diseases. According to the Traditional Chinese Medicine,
it belongs to so called Yang morass. The “Yang morass” affects
external pathogenic energy and eliminates it by clearing an
excess of yang energy in the form of heat. By applying a needle
into this point, we address high temperature in the area of
burn.
Localisation: flexion of elbow—90 , extensor carpi radialis
lonngus, brachialis ligament, in the superficial layer there are
Fig. 1 – Demonstration–localization of the Lung Point 7.
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Fig. 2 – Man 31 years, burnt by boiler wax, burns IIb dg, 1% TBSA, dominant right hand, acupuncture applied up to 24h,
completely healed in 4 weeks without any signs of BT.

branchletsin v. cephalica, in a deeper layer—a. radialisreccu-
rens and n. radialis [11,12] (see Fig. 3).
3.3. Large intestine point—LI 4 (Hegu)
This is a complementary point to the points LU 7 and LI 11.
LI 4 is a homeostatic and immunostimulatory point, which
is primarily an analgesic [13–17] and immunostimulatory
acupuncture point. See Fig. 4.
3.4. Application of ACU within first aid is suitable at all
levels of BT. Significance of an ACU point
a) Lung point 7 on the radial side, at the distal third of both
forearms. Application of two needles is enough (one on
each side). As for locality, it is an easily accessible area and
thus very fast and easily applicable first aid. Therefore, in a
short period of time it is possible to implement acupunc-
ture with potential effects on burn reaction development.
b) Applying needles into the ACU point of LI 11 has rationale
in cases when the point of LU7is hard or impossible to
access. What is more, the needle in LU7 is applied not so
deep and thus there is a danger of its falling out during
patient’s transportation. Compared to this, needle ap-
plication into LI 11 on both sides is very easy, its location
is clear and the needle is applied deeper, and thus there is
not the danger of its released. Another effect of this point
is also elimination of high temperature in the local area
of BT.
c) In case of deep degree and large extent of burns, over 10% of
TBSA, we apply needles not only into LU 7 on both sides, but
also LI 11 on both sides. And in case of deep pain, we apply a
needle into LI 4 on both hands, for a purpose of analgesia
and immunostimulatory effect.
In case of application into LU 7, we use needles of 0.2mm
width and of 15mm length. In case of LI 11 (possibly LI 4), we
apply needles of 0.2–0.3mm width and of 30–40mm length. In
case of field intervention, we apply needles used for intrave-
nous or intramuscular application. What really matters is not
the material, width or length of the needle. (From the point of
view of the Traditional Chinese Medicine, it is ideal if the
needle applied reaches the “qi”, of course.) But what really
matters is: as early application as possible, the sooner from the
beginning of injury the better, often even before dressing. It is
always necessary for the patient to get a follow-up surgical
treatment and to be monitored with their clinical state.
The acupuncture points we suggest are effectively usable and
suitable for all areas and grades of burn injury. Nevertheless,
according to our empirical experiences, they work the best and
the fastest for the upper part of the body (area of face, neck, chest
and upper limbs). Acupuncture within first aid can be also
applied to those burn patients to whom subsequent skin grafting
is indicated because of the depth and intensity of their burns.
1. Reflective—comes within a few seconds after the appli-
cation of acupuncture needles.
2. Vegetative—comes within a few minutes.
3. Neurohumoral—comes within a few minutes.
Indications for Acupuncture:
1. Severe burn.
2. Functional disorders.
3. Pain (caution: acute abdomen).
Contraindications—absolute:
1. Unconsciousness following injury.

Fig. 3 – Man, 34 years, burnt by flame, Ia–IIb degrees, 12% TBSA, burned on the face, neck, both forearms and hands. Acupuncture
applied in 18h after the injury, healed in 4 weeks without any sign of scar after 6 weeks.

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Fig. 4 – Anatomic localization of acupuncture points described above.

Contraindications—relative: 4 weeks. 98,9% were healed with no signs of BT, and without
1. Pregnancy any use of rehabilitation up to 6 weeks. Summary of results of
2. Severe forms of diabetes mellitus. the acupuncture treatment on BT patients (regarding the time
3. Patients significantly affected by analgesics, sedatives, of the 1st ACU application after the BT injury)—see Table 4.
hypnotics. The importance of the time interval (between injury and the
4. Electric shock (risk of cardiac arrhythmias). first acupuncture application) for the final result of treatment
5. Anticoagulation therapy, hemophilia. of BT is presented it the Graph 2.
6. Patients with serious infections (HIV, hepatitis C, . . . ). The development of signs of burns (reddening, pigmenta-
7. Serious psychological distress. tion, scar) on the skin in the dependency on the time interval
8. After transplantation of inner organs. between injury and the first acupuncture application are
9. Serious heart disease and post-operative states. following:
All patients (921) with acupuncture application within 24h
have decreased sign of burns.
4. Set of patients Patients (54) with acupuncture use within 48h: 5.6% i.e. 3
patients after 4 weeks—the reddening is persisted, but without
From 1983 to 2015 a total set of 1008 patients with burns were any signs of the pigmentation or hypertrophic scars. 94.4% i.e.
treated with acupuncture (adults and children). Gender and 51 patients are without any sign of the scar.
age is given in Table 2.
Burn mechanism (see Graph 1), area, burn depth and extent
related to the total number of the patients treated with
acupuncture is presented in Table 3. Table 2 – The structure of patients with BT by gender and
age.
Patients Adults Children
5. Results
Gender Men Women Boys Girls

5.1. Summary of results of acupuncture in burned patients Age (interval) 18–72 18–81 0–17 0–17
Age (average) 33 36 5.4 4.5
Number 117 243 351 297
Patients with minor burns (Ia–IIb) with the extent up to 10%
Percentage 11.6 24.1 34.8 29.5
TBSA were healed without hypertrophic scar formation up to

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Graph 1 – Burn manner mechanism (%).

Patients (24) with acupuncture within 72–144h from the

injury: 16.7% i.e. 4 patients—the reddening was persistent,
83,3% i.e. 20 patients are without any sign of the scar.
Patients (9) with acupuncture within 168–240h: 22.2% i.e. 2
patients—the reddening is persisting after 6 weeks, 11.1% i.e. 1
patient has the pigmentation, 11.1% i.e. 1 patient has the soft
hypertrophic scar. 55.6% i.e. 5 patients have no sign of the scar.
Final results: 98.9% patients suffered from burns and
having been treated by the acupuncture were after 4–8 weeks
without any sign of scar.
Based on our experience with burn treatment we aimed at
the timely treatment, the first acupuncture treatment should
have been applied not later than 24h from injury. That is why
the number of patients treated by acupuncture after this time
limit is low.
5.2. The comparative study
In order to define effects of acupuncture in acute burns, two
sets of patients treated in the period X/2008–VI/2014 were
chosen and then compared:
 Group A counted 198 patients to whom acupuncture was
applied
 Group B counted 63 patients without acupuncture.
Both groups counted patients aged 0.5–81, the burn manner
mechanism was either scalding, flame or contact, the extent of
burn was 0.5–10% TBSA, the depth of burn was IIa– IIb, in all the
areas mentioned above, which means face and neck, chest,
abdomen, back, upper limbs or lower limbs.
According to our empirical experience and monitoring,
wound healing of BT with acupuncture application goes
through all stages typical of wound healing. The time of
healing is given by the time within which acupuncture is
applied.
Results of the comparison of both sets—see Table 5.
For demonstrating the effect of acupuncture treatment
(regardless the time of application) the x2 test was used. The
final p-value (7.410 43) showed significantly that acupunc-
ture effects are not coincidental. On the contrary, acupuncture
use positively affects the treatment outcome (the BT signs on

Table 3 – Burn mechanism, area, burn depth and extent.

Burn manner mechanism % Area % Burn depth % Extent-TBSA (%) %
Flame 11.4 Face +neck 8.1 I–IIa (surface) 30.6 0.5%– 5% 62.5
Scalding 84.6 Chest 36.9 IIa–IIb (surface–deep) 62.2 6%–10% 35.6
Chemical 1.1 Abdomen 5.5 IIb (deep) 7.2 11%–15% 1.8
Contact 2.7 Back 3.6 16%–20% 0.1
Electricity 0.1 Upper limb 30.6
Explosives 0.1 Lower limb 15.3

Table 4 – Results—patients treated with acupuncture.

Results with ACU Total No signs of prior Reddening Pigmentation Hypertrophic scars
number burns (number) (number) (number)
Within 0,5 h 81 81 100.0% 0 0.0% 0 0.0% 0 0.0%
Within 1,0 h 180 180 100.0% 0 0.0% 0 0.0% 0 0.0%
Within 2,0 h 378 378 100.0% 0 0.0% 0 0.0% 0 0.0%
Within 12 h 108 108 100.0% 0 0.0% 0 0.0% 0 0.0%
Within 24 h 174 174 100.0% 0 0.0% 0 0.0% 0 0.0%
Within 48 h 54 51 94.4% 3 5.6% 0 0.0% 0 0.0%
After 72–144 h 24 20 83.3% 4 16.7% 0 0.0% 0 0.0%
After 168–240 h 9 5 55.6% 2 22.2% 1 11.1% 1 11.1%
Total 1008 997 98.9% 9 0.9% 1 0.1% 1 0.1%

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Graph 2 – Signs on the skin—in dependence on the first ACU application.

Table 5 – Results—patients treated with ACU (Group A) and without ACU (Group B).
Group A: 0,5–10% TBSA (IIa–IIb) Number of No signs of prior Reddening Pigmentation Hypertrophic scars
patients burns (number) (number) (number) (number)
ACU within 0,5 h 6 6 3.0% 0 0.0% 0 0.0% 0 0.0%
ACU within 2,0 h 63 63 31.8% 0 0.0% 0 0.0% 0 0.0%
ACU within 12 h 81 81 40.9% 0 0.0% 0 0.0% 0 0.0%
ACU within 24 h 36 36 18.2% 0 0.0% 0 0.0% 0 0.0%
ACU within 48 h 9 8 4.0% 1 0.5% 0 0.0% 0 0.0%
ACU after 168–240 h. 0 0.0% 1 0.5% 1 0.5% 1 0.5%
ACU total 198 194 98.0% 2 1.0% 1 0.5% 1 0.5%
Group B: no ACU 63 9 14.3% 26 41.3% 1 1.59% 27 42.9%

the skin). The Pearson's contingency coefficient (0.653) and the 5. This method of treatment saves important costs.
Cramer's contingency coefficient (0.862), as well, are showing 6. Lower psychosomatic or psycho-social impacts.
that this dependency is relatively strong.
Fig. 5 demonstrate two patients from the comparative
study. 6. Case

5.3. Our empirical experience Acupuncture applied in 30min after injury. Demonstration of
patient with timely application of acupuncture is given in
From our empirical experience we noticed: Fig. 6.

1. Timely application of the first acupuncture treatment is

beneficial—the earlier the application (up to 30–120min) it
appears that the results is best acupuncture may trigger
the recursion of all initiated pathological processes.
2. With some potential effect of the systemic reaction (burn
shock is reduced), also thanks to the effects of acupuncture,
infection does seem to occur and immunodeficiency
induced by cytokines does not occur [18]. (For non-severe
cases: complete healing ad integrum.)
3. We note that with acupuncture use, analgesics and
sedatives are used less often.
4. According to our empirical experience with BT gr. IIb: in
case the acupuncture was applied early after the injury, the
injury did not deepen into gr. III and the process of healing
was equal to burn gr. IIa.
7. Discussion
The results of our empirical study can be supported by the
results of the study by Lee et al. who claim that acupuncture
accelerates wound healing using activation of angiogenic
growth factors [19]. In our study, the patient in order not to be
traumatized even more, histological examination was not
carried out, namely because of the fact that almost 2/3 from the
whole number of patients were children.
Our practical results are also consistent with the results of
the study by Lee et al., whose study demonstrates that ACU
accelerates the skin regeneration process and participates in
effective wound healing [20].

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8 burns xxx (2017) xxx –xxx
Fig. 5 – Man with BT treated with ACU and woman with BT
treated without ACU.
Description of Fig. 5: BT treated with ACU: Man, 34 years,
burnt by flame, face, both hands, forearms, neck gr. IIb, face
gr. IIa. 12% TBSA. ACU applied within 18 h. Healed in 4 weeks.
No signs of burns after 6 weeks.
BT treated without ACU: Woman, 26 years, burnt by flame,
left hand and forearm, both arms (front side), chest front
upper part gr. IIb-(III). 14% TBSA. Autotransplantation,
healed in 4 weeks. 6 weeks after the BT with dark reddening.
Acupuncture proved to be a benefit to burn care also in a
study by Ayse Ebru Abali et al. [21].
All the studies mentioned above were carried out on mice
and rats. Obviously, the location of ACU points on mice and
rats are different from the location of ACU points on a human
body.
Using ASHI points and Back-SHU points in case of rats
makes sense.
ASHI points are points with high palpation tenderness and
at high percentage; they correspond with active ACU points.
ASHI points applications treat acute painful conditions in the
field (skin in case of BT). Likewise, needles were applied
interdigitally. Extra points BAXI have a strong analgesic effect
Fig. 6 – Demonstration of patient with timely application of ACU, boy—1.5 years, scalded on the left lower limb with b oiling
water, IIa–IIb, 5% TBSA. ACU applied in 30min after trauma. Hospitalized for 5 days, local dressing, without any painkillers and
sedatives, healed in 4 weeks with no signs of burns.
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and influence on the skin healing in the affected area. Back-
SHU points, according to Traditional Chinese Medicine (TCM),
are found in the first line of a Bladder Channel, and apart from
other indications they are generally used for ACU to regenerate
and harmonise the functional state of organs. E.g. Bladder
Channel point (BL-13) is a back transmission point for the lungs
affecting skin healing. According to evolutionary embryology:
lungs and skin are part of the ectoderm.
Burns are primarily external along the acupuncture point’s
channels of individual organs. Therefore, acupuncture appli-
cation in the back transmission points, on the first line of the
Bladder Channel, is justified. Acupuncture applied on the
second line of the Bladder Channel has an important influence
on patient’s mental state.
Every acupuncture application into active points (until the
feeling of Chi) always intervenes in the central nervous
system. Acupuncture points choice in burns we indicated
according to:
a) our empirical experiences,
b) the theoretical point of view of the Traditional Chinese
Medicine,
c) the point of view of embryology (skin, CNS, lungs, large
intestine—ectoderm) and (soft tissues, vessels, kidney—
mesoderm).
Acupuncture suggested by us is the most suitable and
usable and the points introduced in this study are very specific
for burns. From the TCM point of view LU 7, LI 4 a LI 11 and ST
36 belong together (known as “Ma Danyangxue points”), what
is 12 the most important points in acupuncture application.
Very easy application of two needles is just a bonus.
Nevertheless, we do agree with the conclusions of the third
mentioned study on rats, which prove lowering pain and post-
traumatic stress, improving microcirculation better wound
healing with using acupuncture in complex therapy for burns.
There have been so many studies carried out to clarify effects
of acupuncture on patients, and due to fast laboratory
development and RTG methods many more are coming. From
those having been published so far I would like to point out the
theory of influence of acupuncture on the central nervous
system (Flandin, 1933, Fuye, 1950, Daniaud 1964, Stiefvater,

1956, CžuLja  , 1959 a Mann F., 1970). As a result of acupuncture
n
application, feedback systems in the central nervous system get
JBUR 5267 No. of Pages 10
burns xxx (2017) xxx –xxx
activated on all levels, from the spinal ones to the brainstem,
cerebellar, hypothalamic, thalamic, extrapyramidal and
corticalones.
Another theory explaining acupuncture effects is the
bioplasmatic theory (Sedlak 1967, Injušin 1969). Configuration
and frequency and energy spectrum of bioplasma are condi-
tioned by physical and mental state of the organism and even
by external environmental factors. They are a reflection of
feedback relations with immunological, biochemical and
electrical processes in the organism and thus even a source
of information on an actual state of the organism.
Another very important theory is the endorphin theory
(Pomeranz, 1976). It is the latest physiological interpretation of
neurohumoral effects of acupuncture, namely in the field of
inner analgesic system activation.
Pomeranz explains hypalgesic effects of acupuncture.
Needle application into an active point irritates deeply
embedded sensitive nerve endings. By afferent impulses,
there are substances released from diencephalon and pituitary
gland which chemically resemble morphine [22,23].
Acupuncture points can be understood as a subsystem,
which has the nature of the adaptive system, where they are
incorporated memory and feedback.
Using acupuncture in a complex therapy for burns has a
huge potential. And still, despite all the existing studies, there
is still a long way to go for a scientific research acupuncture for
burns. We would appreciate our 30 years of mainly empirical
studies to inspire and encourage others to further scientific
studies on this topic.
We are aware of our limited possibilities in the field of
laboratory, radiological and other examination at the onset of
our study (1983) compared to those which could be performed in
recent years. Moreover, we applied acupuncture frequently in
terrain (car crashes, fires), etc. Our work should inspire others to
perform scientific evidence using the latest technology.
8. Inspiration for follow-up research studies
Based on our follow-up with a large number of patients, from
the medical point of view, application of acupuncture as the
first aid treatment for acute burns and its subsequent therapy
leads to:
1. diminished development of post-traumatic stress
2. reduced occurrence and reduction of a burn shock
3. timely-analgesia (diminished pain intensity) [19,20]
4. immunostimulatory effect
5. shorter subsequent healing
6. stream improvement (elimination of dynamic insuffi-
ciency of venous and lymphatic system and improves
microcirculation)
7. Reduction of hypertrophic scar development
8. bio-medical-psycho-social effect
9. Conclusion
For demonstrating the effect of acupuncture treatment
(regardless the time of application) the x2 test was used. The
Please cite this article in press as: A. Loskotova, J. Loskotova, The use of acupuncture in first aid of burns—Clinical report, Burns (2017),
http://dx.doi.org/10.1016/j.burns.2017.04.025
9
final p-value (7,410 43) demonstrated positive effect on the
outcomes measured by the authors.
Using of acupuncture seems to have positive effects on the
results of burn. The Pearson's coefficient (0,653) and the
Cramer's contingency coefficient (0,862), as well, are showing
that this is potentially effective in some, but not all.
What we find very important, it is the “time factor” of an
early acupuncture application from the beginning of all
degrees, localisations and extent of burn. Dealing with I—IIa
burns and of lower extent, pain relief comes within 15min
from acupuncture application. (It depends on clinical state of
the patients, their personal anamnesis and mental state—for
children a mental state of their parents or other close relatives
is also important).
By adding acupuncture to basic therapy, we sought to
achieve faster healing and better results. Its application
significantly reduces the duration of the treatment and in
many cases contributes to overall recovery.
With respect to the health system of the country, with a few
modifications it can be applied in every country (especially
low-income countries) because of the easiness, low-cost and
high efficiency of the therapy.
Remark
All acupuncture applications, and presentations on Con-
gresses, as well, were financed by the authors.
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Please cite this article in press as: A. Loskotova, J. Loskotova, The use of acupuncture in first aid of burns—Clinical report, Burns (2017),
http://dx.doi.org/10.1016/j.burns.2017.04.025