摘要：Hypertrophic scars, resulting from alterations in the normal processes of cutaneous wound healing, are characterized by proliferation of dermal tissue with excessive deposition of fibroblast-derived extracellular matrix proteins, especially collagen, over long periods, and by persistent inflammation and fibrosis. Hypertrophic scars are among the most common and frustrating problems after injury. As current aesthetic surgical techniques become more standardized and results more predictable, a fine scar may be the demarcating line between acceptable and unacceptable aesthetic results. However, hypertrophic scars remain notoriously difficult to eradicate because of the high recurrence rates and the incidence of side effects associated with available treatment methods. This review explores the various treatment methods for hypertrophic scarring described in the literature including evidence-based therapies, standard practices, and emerging methods, attempting to distinguish those with clearly proven efficiency from anecdotal reports about therapies of doubtful benefits while trying to differentiate between prophylactic measures and actual treatment methods. Unfortunately, the distinction between hypertrophic scar treatments and keloid treatments is not obvious in most reports, making it difficult to assess the efficacy of hypertrophic scar treatment.

摘要：One hundred and thirty-eight (138) patients, with five hundred and sixty-six (566) different burn sites with different degrees, severity and locations, were enrolled to a multicenter clinical trial at 25 study centers. The goal of this trial was to evaluate the efficacy of MEBO (Moist Exposed Burn Ointment) in the treatment of burn wound. Various parameters were studied including: (i) healing time, (ii) need for pain killers, (iii) consumption of i. v. Fluids, (iv) use of systemic antibiotics and (v) aesthetic appearance. There was remarkable decrease in the healing time and most patients either did not need any pain killer or were relieved with only mild analgesics, except in few cases of deep second degree and third degree burns. A decrease in the volume of i. v. fluids needed was also reported. Only 19% of cases developed clinical infection, especially in those who were not treated with MEBO immediately post burn. Even though systemic antibiotic treatment was prophylactically implemented in most cases as a routine measure, 32 cases did not receive any antibiotic prophylaxis with MEBO and yet did not develop any infection. The aesthetic appearance reported was very acceptable. This treatment modality was not associated with any side effects, and patient discomfort during application and change was negligible. Thus, MEBO treatment was associated with excellent and relatively faster healing, low incidence of wound infection, and excellent patient compliance.

摘要：Cosmetically unacceptable pigmentation changes and hypertrophic scarring often complicate split thickness skin graft (STSG) donor sites. In fact, patients often ask about other alternatives when confronted with the need to harvest STSG, particularly because they fear additional disfigurement. Because recent evidence suggests that a moist environment promotes more optimal healing, we conducted a limited controlled and comparative study to assess the effect of a newly introduced burn ointment MEBO (Moist Exposed Burn Ointment) (Julphar Gulf Pharmaceutical Industries, Ras Al-Khaimah, UAE) on re-epithelialization and healing of STSG donor sites as compared with the conventional Sofra-Tulle semi-open dressing (Roussel Laboratories Ltd., Uxbridge, England). We observed that MEBO treated areas were completely reepithelialized within 5 to 6 days while conventionally treated areas required 10 to 12 days to heal.

摘要：Objective:The objective is to outline the overall health scene as it is in New Zealand and to demonstrate that there is tremendous potential for the increased use of Moist Exposed Burn Therapy(MEBT)across a wide variety of health care facilities within New Zealand.Method:The presentation allows me to share with you evidence from clini- cal based practice and examples of how and where MEBT and the product Moist Exposed Burn Ointment(MEBO)has been used within New Zealand' s health services.This will include evidence from other nursing colleagues who work in the Aged Care sector or in the New Zealand community.Result:My experiences in the clinical field have enabled me to see that there is much that can be done through education for nurses by professional nurse educators. Currently there is little or no funding available to Nurse Educators for them to be able to provide the required education and training,or to be able to introduce the correct clini- cal techniques of MEBT into our heahhcare profession. Patients who require wound management and have been treated using the MEBT method are provided with sustained wound healing,improved outcomes and consequently an improved quality of life. New Zealand health providers are beginning to realize that use of MEBT and MEBO is a cost effective form of treatment.Not only in monetary terms but in ethical and physiolog- ical terms as well.At this point in time however,there is evidence that nurses will experi- ment with products such as MEBO but revert back to techniques and products they know and are comfortable with in day to day nursing situations. It can therefore be concluded that New Zealand nurses do not have adequate knowl- edge or understanding of the clinical application of MEBT/MEBO to achieve the optimum results for their patients. Ongoing education is essential to ensure that nurses,who are using MEBT,under- stand the principals of MEBT and follow the correct clinical application. There has been evidence,during my clinical practice,of New Zealand nurses using MEBT alongside the current New Zealand wound management techniques and this combi- nation has often led to a misunderstanding about MEBT and the incorrect use of MEBO. As a result the patient outcomes are often substandard compared with the recommen- ded MEBT practice and the resulting potential for the increased quality of life is not fully realized by patient or practitioner. With the acceptance of a changing methodology and its education within the New Zea- land nursing culture,there is significant potential for this wound management concept to be widely used,particularly within the Aged Care and Disabilities sectors within New Zea- land prior to registration of MEBO being granted. With the full registration of the MEBO product,we will be able to use this treatment to its full potential to provide improved patient outcomes and an increase in quality of life for patients within New Zealand. My clinical knowledge of MEBT has helped me to initiate a starting point of MEBT education in New Zealand-currently focused on regional nurse education and community awareness.This will help facilitate the understanding,enthusiasm and commitment for this treatment across New Zealand and enable nurses to gain the necessary support to bring a- bout this change in wound management.