摘要:BACKGROUND? There is growing evidence of improved healing of full- and partial-thickness cutaneous wounds in wet and moist environments. Retention of biologic fluids over the wound prevents desiccation of denuded dermis or deeper tissues and allows faster and unimpeded migration of keratinocytes over the wound surface. It allows also the naturally occurring cytokines and growth factors to exert their beneficial effect on wound contracture and re-epithelialization. Despite all of these documented benefits, applying the moist healing principles to large surface areas, in particular to large burns, is hindered by the major technical handicap of creating and maintaining a sealed moist environment over these areas. METHODS? From January to September 2001, healing of partial-thickness skin graft donor sites was studied in a prospective comparative study of two types of moist dressings, Tegaderm (3M Health Care, St. Paul, MN), a semipermeable membrane occlusive dressing, and moist exposed burn ointment (MEBO) (Julphar; Gulf Pharmaceutical Industries, United Arab of Emirates), an ointment that can provide a moist environment without the need of an overlying occlusive dressing. Healing was assessed both clinically and with serial measurements of transepidermal water loss (TEWL) and moisture. Following healing, scar quality was evaluated by two members of the team separately using a visual analog scale. Results were statistically analyzed. RESULTS? Faster healing was observed clinically with MEBO application. Physiologic healing as determined by TEWL measurements occurred at an extremely significant earlier stage for MEBO, and this was associated with better scar quality, demonstrating a positive relationship between function and cosmetic appearance. Moreover, the ointment is definitely easier to apply than the occlusive self-adhesive membrane, which requires some degree of dexterity and expertise. CONCLUSION? MEBO application is an effective and valid alternative to conventional occlusive dressings. Moreover, the observed improved anatomic and physiologic healing indicates that MEBO may have a positive effect on healing more that the mere fact of passive moisture retention.
摘要:Burn rehabilitation; Hand function; Scar evaluation; MEBO
摘要:目的 :总结在预防SARS期间应用过氧乙酸不当导致烧伤的发病特点与治疗经验。方法 :对10 2例过氧乙酸烧伤患者应用美宝湿润烧伤膏 (MEBO)治疗 ,总结其临床特点及治疗体会。结果 :疗程结束时治愈率 10 0 % ,其中Ⅰ度烧伤平均止痛时间 3 78± 230分钟 ,皮损消失时间 9 30± 1 5 0小时 ;Ⅱ度烧伤平均愈合时间 66 1± 1 37天。 80 %的患者由于长时间接触过氧乙酸而导致烧伤。结论 :在预防SARS期间使用过氧乙酸时应严格按要求使用 ,MEBO对过氧乙酸烧伤有确切疗效
摘要:Objectives. Fournier’s gangrene (FG), though rare, is a life-threatening extensive fulminant infection of the genitals, perineum, or abdominal wall caused by a mixture of aerobic and anaerobic micro-organisms. Early and aggressive surgical debridement of the necrotic tissue and complete antibiotic coverage are the gold standards in treating FG. The purpose of our study was to assess the role of MEBO (moist exposed burn ointment) in topical treatment of the wound secondary to surgical debridement. Methods. Eleven patients (age range, 40-75 yr; mean, 55 yr) were admitted to the clinical facilities of the Department of Urology at Al Sabah Hospital, Kuwait, suffering from Fournier’s gangrene, in the 31-month period between January 2004 and July 2006. All these patients were treated with broad-spectrum triple antimicrobial therapy as well as extensive debridement of necrotic tissue. The resultant wounds were treated with MEBO in six randomly selected patients and with a placebo in the remaining five patients. Results. The duration of hospital stay was reduced by 41.7% in the MEBO-treated group (30.0 vs 51.5 days) and pain control of pain was faster, which could be attributed to the faster control of infection and wound healing in this group. Conclusion. A combination of appropriate antibiotic coverage and aggressive surgical therapy is mandatory for the treatment of FG. MEBO promotes the healing of the resulting, quite extensive wound, reducing pain and controlling infection. It is a also a cost-effective therapy as it accelerates healing and reduces hospital stay by 41.7%.