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Burn Regenerative Medicine and Therapy (BRT with MEBO/MEBT)

编辑:Rong Xiang Xu 出版社:KARGER 发行日期:In 2004

Indications:
BRT with MEBT/MEBO is an independent method:
1. For treating superficial second-degree and deep second-degree burns and scald wounds of various causes and in different areas.
2. In coordination with cultivating and relieving techniques, BRT can be used for treating full-thickness dermis burns and scald wounds, provided viable subcutaneous tissue of various causes and different areas are present.
3. For treating burns wounds deep in the muscular layer with diameters of less than 20 cm.
4. For treating wounds at the skin donor site.
5. For treating granulation wounds deep in the muscular layer, for promoting regeneration of granulation tissue in burned bone after debridement, and to create a physiological environment at the receiving site for skin grafting.
6. For treating all kinds of surface wounds.
7. For treating other skin lesions including hemorrhoids, leg ulcers, bedsores, chronic ulcers, infected wounds, chilblains, etc.

Clinical Application
Direct application of MEBO – a specially developed topical drug for BRT with MEBT/MEBO -- onto the wound surface to a thickness of 0.5 mm ~ 1.0 mm every 4~6 h. Detailed clinical treatment is recommended as follows:

1. For first aids at home (especially in kitchen). Immediately apply MEBO on the wound to relieve pain, stop bleeding, alleviate injuries and prevent infection in cases of scalds and burns by hot oil, boiling water, or friction burns. The sooner, the better. The consequent treatment should be conducted according to the following specific cases.
2. Treatment for first-degree burns or scalds: Directly smear MEBO onto the wound 2~3 times daily.
3. Treatment for superficial second-degree burns or scalds: Directly smear MEBO onto the wound to a thickness of 0.5 mm ~ 1.0 mm. Renew the ointment every 4~6 h, before doing so gently wipe off any residual ointment and exudates. It usually takes 6~7 days to heal. Blisters, if present, should be punctured and discharged while blister skin should be kept intact in the early stage. No disinfectant, saline or water is required or in fact even allowed except in the case where exogenous toxins remain at the site such as might be the case with chemical burns or other dirty wounds. Patient sustaining moderate or extensive burns should be sent to hospital or a clinic experienced with the BRT treatment protocols.
4. Treatment for deep second-degree burns: Treatment in the early stage is the same as that for superficial second-degree burns. Remove the blister skin on day 5~6 post injury. As the dermis tissues are damaged and white in color, the application of MEBO should be continued on the wound to a thickness 0.5 mm ~ 1.0 mm every 4 h. White metabolic products resulting from liquefaction of necrotic tissue by the ointment will appear on the wounds (do not misdiagnose this cleansing process as infection). Be sure that the residual ointment and white liquefied products are wiped off gently (do not irritate or debride the tissue) before reapplying MEBO. Allow another 6~7 days for the necrotic tissue to be liquefied and discharged completely, then continue the above treatment using less dosage of MEBO until the wound heals. In the event that the wound is still not healed after 25 days postburn, the diagnosis should be changed to full-thickness degree. In brief, the venerable medical principle of “primum non nocere” (first do no harm) and of  “no secondary injuries” should be honored during the whole treatment procedure. We accomplish that by: (1) protection of the treated wound in the early stage from further injuries (avoid any measures, which may irritate, debride or exacerbate wounds). (2) liquefaction and removal of the necrotic tissue without causing secondary injuries. (3) regeneration and skin repair without causing secondary injuries (any method which may irritate or damage the wounds is not allowed). Patients sustaining moderate and extensive burns should be sent to hospital or a clinic with experiences of BRT and MEBT for appropriate treatment.
5. Treatment for third-degree burns: For the small-area burn wound, we recommend cultivating tissue and then preparing the lesion for application of MEBO through gentle loosening of necrotic tissues by scratching with a specially designed device -- “plough saw blade” is the appropriate treatment for the deep second-degree burns wounds. For larger burns wounds, the aforementioned method is adopted if the patient’s systemic condition is stable. The principle of “no secondary injuries” should be followed strictly during the treatment. Patient sustaining third-degree burns must be hospitalized at clinics offering care from clinicians experienced in BRT with MEBT/MEBO.
6. In the treatment of small burns wounds occurring in inconveniently exposed body parts, bandaging is recommended. However, dressing changes and renewal of MEBO ointment at a thickness of 2 ~ 3 mm every 12 h is recommended. Contrary to the typical dressing change protocol, however, rather than debride the wound beneath the bandage, we recommend that the bandage be gently removed leaving the residual ointment and metabolic products to continue their cleansing activity.
7. Treatment for other superficial trauma wounds including abrasion, friction burns and skin cracking, stasis ulcers: Treat the ulcer wounds according to the instructions for either superficial or deep second-degree burns, or dress the wounds with MEBO in accordance with the surgical methods. However, any disinfectant, antiseptic or saline is contraindicated as they are both unnecessary and deleterious to wound health.
8. Treatment for hemorrhoids: Directly apply MEBO onto the affected area every morning and evening, or smear MEBO onto the postoperated wound to relieve pain and promote healing.

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