摘要：目的:探讨湿润烧伤膏(MEBO)在防治小儿包皮口狭窄、包皮垢残留及包皮龟头粘连分离术后创面疼痛及再粘连的疗效。方法:2005年1月～2007年10月门诊156例包皮口狭窄、包皮垢残留及包皮龟头粘连症的儿童,随机分为湿润烧伤膏治疗组(MEBO治疗组)及红霉素软膏对照组(EY对照组),均采用包皮口扩张、包皮垢清除及包皮龟头粘连分离术治疗,术后疼痛采用视觉类比量表(Visual analongue cale,VAS)对两组术后3个时间段疼痛程度进行对比,对比痊愈情况,同时术后观察三个月,包皮是否再粘连。结果:VAS评分比较,术后3个时间段分别是:EY对照组为5.15±1.36,6.19±1.64,4.43±2.06;MEBO治疗组为3.26±1.42;2.17±1.50,1.15±1.20;两组3项指标比较均有显著性差异(P<0.01)。术后痊愈情况:EY对照组平均痊愈时间为4.81d±0.91d;MEBO治疗组平均为3.70d±0.99d;术后三个月返院及随访复查132例,是否再粘连,EY对照组发生率为29.23%(65/19),MEBO治疗组发生率为2.98%(65/2),两组各项指标比较均有显著性差异(P<0.01)。结论:应用MEBO治疗小儿包皮口狭窄、包皮垢残留及包皮龟头粘连症,行包皮口扩张、包皮垢清除及包皮龟头粘连分离术,术后损伤创面的止痛效果可靠,创面愈合快,防止再粘连疗效显著。

摘要：目的:观察湿润烧伤膏(MEBO)在陈旧性肛裂术后创面愈合过程中的疗效和作用。方法:将80例陈旧肛裂术后患者随机分为MEBO纱条组(治疗组)和凡士林纱条组(对照组),各40例,治疗组每日予以MEBO纱条换药,对照组每日予以凡士林纱条换药,观察术后创口疼痛(VAS法)、水肿、出血、痊愈时间、愈合率等指标。结果:MEBO治疗组VAS疼痛指数第4天为3.64±0.51,第7天为1.42±0.24;创口水肿指数为0.42±0.10;创口出血指数为8.34±1.40;创口痊愈时间为15.20±2.00及术后第9天、14天愈合率为48.11±9.04、88.40±5.88均优于对照组(P<0.05)。结论:湿润烧伤膏(MEBO)对减轻陈旧性肛裂术后疼痛、创口水肿、出血及促进术后创口愈合具有良好治疗作用。

摘要：The history of wound care and management closely parallels that of military surgery which has laid down the principles and dictated the practices of wound cleansing, debridement and coverage. From a treatment standpoint, there are essentially two types of wounds: those characterized by loss of tissue and those in which no tissue has been lost. In the event of tissue loss it is critical to determine whether vital structures such as bone, tendons, nerves and vessels have been exposed. It is also important to determine the amount of soft tissue contusion and contamination. In any case primary wound healing by early closure either primarily or with the help of grafts or flaps is preferred to secondary healing and wound contraction with subsequent contractures which interfere with range of motion and function. Whether the wound is acute or chronic, essential principles of wound care must be observed in order to avoid wound sepsis and achieve rapid and optimal wound healing. - Tissues must be handled gently. - Caustic solutions capable of sterilizing the skin should never be applied to the wound. It is desirable never to put anything in the wound that cannot be tolerated comfortably in the conjunctival sac. - All devitalized tissues must be debrided either hydrodynamically, chemically, mechanically or surgically. - All dead space must be obliterated. - Exposed vital structures must be covered by well vascularized tissues. An essential part of any wound management protocol is wound dressing. It cannot be too strongly emphasized that a wound dressing may have a profound influence on healing particularly of secondary type healing, a critical feature being the extent to which such dressing restricts the evaporation of water from the wound surface. A review of available dressing materials is reported with emphasis on the newly developed concept of moist environment for optimal healing. a practical guide for dressing selection is also proposed.

摘要：Introduction The objective of this study was to investigate the clinical effects of laser therapy in treating cicatricial ectropion. Methods Seven patients with cicatricial ectropion were entered into this clinical study. The ectropions were pretreated with the 595-nm pulsed dye laser if the scar color was red. If there was no red, the UltraPulse fractional CO2 laser was used and parameters were adapted according to the height of scar. MEBT/MEBO was used after laser treatment for wound healing. The degree of ectropion was measured for changes before and after treatment, and the scars were evaluated for changes in melanin, height, vascularity, and pliability using the Vancouver Scar Scale (VSS) before and after treatment. Results All seven patients with cicatricial ectropion entered into this protocol were completely corrected after 1-2 treatment sessions. The total VSS score, as well as the score for melanin and pliability in 7 patients, showed a decrease following the treatments, and this was statistically significant (P < 0.05). The scores for height and vascularity showed a decrease following the treatments, but there was no significant difference by statistical analysis (P ≥ 0.05). There were no adverse reactions reported. Conclusions The treatment of cicatricial ectropion with laser therapy can not only correct the ectropion, but also improve the scars in the treatment area. Compared with the traditional repair of cicatricial ectropion, the use of fractional CO2 laser provides surgical precision and the advantage of a timely treatment without the need to wait for the scar to stabilize.