Hilotherapy involves administering regulated cold compression through a facemask. The principle of this treatment involves cyotherapy as a traditional treatment for reducing inflammation, pain and swelling following trauma. It is believed that using hilotherapy (Hilotherm®), which uses a mask to channel a current of cool sterile water adjacent to skin, provides regulated cryotherapy better than traditional cold compression. The masks could either be upper and midface or middle and lower face masks. The authors performed a systematic review and meta-analysis of the literature to investigate this. They included randomised controlled trials that compared facial cooling with hilotherapy, with standard dressings or cold compression after facial surgery. Four studies with a total of 146 patients were included in the authors’ analysis. The primary outcome measures were oedema and pain whilst secondary outcome measures were tolerance, haematoma and ecchymosis.

The temperature administered for hilotherapy was 14-15°C for all studies and treatment was administered immediately postoperatively. The duration used varied from 45 minutes up to 72 hours. The authors concluded that hilotherapy showed a benefit in reducing postoperative pain, facial oedema and had better patient satisfaction.

They did not find evidence that hilotherapy reduced postoperative haematoma or ecchymosis. The limitation of this study, however, is that all the trials used for the meta-analysis were from the same investigators due to the paucity of studies available. Further studies are needed. However, with the cooling unit costing £4500 (November 2015), there may not be many units that could afford this treatment.

Hilotherapy for the management of perioperative pain and swelling in facial surgery: a systematic review and meta-analysis.
Glass G, Waterhouse N, Shakib K.
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Wai Sum Cho

Queens Medical Centre, Nottingham, UK.

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