摘要:给予2021年11月广西中医药大学第一附属医院收治的1例Wagner 4级糖尿病足患者于外科清创手术后,采用皮肤再生医疗技术(moist exposed burn therapy/moist exposed burn ointment, MEBT/MEBO)治疗18天后创面大部分愈合,可见上皮爬行,出院后1~3月电话随访,双足趾创面愈合,愈合皮肤良好,双足趾感觉及活动无明显异常,报道如下。
摘要:This meta-analysis aimed to assess the effectiveness of moist exposed burn ointment (MEBO) for diabetic foot ulcers (DFU). Two researchers independently assessed the quality and validity of included randomized controlled trials (RCTs) in 7 electronic databases. Risk of bias was assessed using Cochrane handbook guidelines. Twenty seven trials which include 1,979 patients were involved for analysis. Comparison of the same intervention strategies revealed significant differences in total effectiveness rates between BEBO and conventional therapy group (Risk Ratio [RR], 6.36, [95% confidence interval (CI), 3.20, 12.64], P < 0.00001); MEBO combined with standard therapy (Risk Ratio [RR], 1.19, [95% confidence interval (CI), 1.08, 1.31], P = 0.0007); and healing time of DFU (Mean Difference [MD], 14.15, [95% confidence interval (CI), -18.14, -10.17], P < 0.00001). MEBO may be effective for treating DFU. However, a firm conclusion could not be reached because of the poor quality of the included trials. Further trials with higher quality are justified. Key words: Exposed wound ointment (MEBO), diabetic foot ulcers (DFU), recombinant bovine, basic fibroblast growth factor (rb-bFGF), vacuum sealing drainage (VSD).
摘要:Objective:Moist Exposed Burn Ointment(MEB0)has been initially popularized by the Beijing Chinese Burn Center as a topical burn oint- ment capable of providing the necessary moist environment for optimal wound healing without an overlying secondary cumbersome bulky and expensive dressing. Chinese traditional medicine(CTM)is quite different from the type of medicine and approach to disease as practiced in the west. Despite its empirically time proven practices and remedies,it is difficult,however,to accept CTM without adapting it to western ways of scientific analysis and documentation and many obstacles must be overcome before adopting it in a western style medical practice.Methods:Even though the effects of MEBO have been well described in the Chinese literature,the ointment had to be sub- jected to our ways of scientific analysis and documentation before being adopted.Sev- eral clinical studies were conducted to demonstrate the effect of MEB0 on primary healing of surgically repaired cutaneous wounds and on secondary healing of split thickness skin graft donor sites. Its effect on scar quality following both primary and secondary healing was also elucidated.Wound healing cytokine modulation by MEBO was investigated experimentally using the rabbit burn model.Results:Split thickness skin graft donor site wounds treated by the moisture retentive ointment had faster re- epithelialization rate than conventionally treated wounds with Sofra-Tulle or with oc- clusive Tegaderm dressings and were markedly less hyperemic and pigmented. Final cosmetic appearance as documented photographically,as well as patient's satisfaction and preference were much superior for the MEB0 treated wounds.It was demonstrated also that the ointment under investigation not only provided optimal and rapid re-epi- thelialization of partial thickness wounds but also resulted in faster functional cutaneous recovery as determined by TEWL(trans-epidermal water loss)measurements.It re- suited also in better quality healing as evidenced by lack of epidermal sliding.The ex- perimental study demonstrated that the multitude of inflammatory cells,growth factors and cytokines present in the wound bed are positively modulated by topical application of MEBO with characteristic temporal and spatial regulation and changes in the expres- sion pattern.Conclusion:Despite the fundamental differences between CTM and west- ern style medicine,it is wrong to totally disregard CTM only because some of its ingre- dients are unknown to our pharmacopea or because the complex nature of the Chinese medicinal preparations preclude isolation of the various constituents for exact toxicologi- cal and pharmacological investigation either separately or in combination with each oth- er.Our studies have clearly demonstrated the beneficial effects of MEBO on wound healing and scar quality.This effect is not merely due to moisture retention but rather to a fundamental basic modulation of wound healing kinetics.Furthermore,the experi- mental study has proven that wound healing modulation could be achieved by simple ointment application without the need of sophisticated and expensive high-tech mo- dalities such as cytokine and gene therapies.
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.