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.

摘要：Microskin graft is a technique of skin defect closure using a minimum of STSG donors to cover the large defect. Some considerations were taken, which includes the general status of the patient, donor area morbidity, and patient refusal to act is one of the reasons for the use microskin graft. History STSG failure with previous defect closure and lack of donor area would to bene!t from microskin graft. Case of boy 12 years old with extensive defects in the forearm due to burns. Consideration of the lack of donor area made us deciding to use microskin graft as main option to close the defect. We did one-week post operative evaluation. Epithelialization occurs at day 7, while complete epithelialization occurred at 14th day. Three month during follow-up control, the scar are minimal. We conclude that microskin graft is one technic that can be used in skin defect closure with minimal donor.

摘要：Objective: The goal of any topical formulation is efficient transdermal delivery of its active components. However, delivery of compounds can be problematic with penetration through tough layers of fibrotic dermal scar tissue.Approach: We propose a new approach combining high-performance liquid chromatography (HPLC) and Raman spectroscopy (RS) using a topical of unknown composition against a well-known antiscar topical (as control).Results: Positive detection of compounds within the treatment topical using both techniques was validated with mass spectrometry. RS detected conformational structural changes; the 1,655/1,446?cm?1 ratio estimating collagen content significantly decreased (p?<?0.05) over weeks 4, 12, and 16 compared with day 0. The amide I band, known to represent collagen and protein in skin, shifted from 1,667 to 1,656?cm?1, which may represent a change from β-sheets in elastin to α-helices in collagen. Confirmatory elastin immunohistochemistry decreased compared with day 0, conversely the collagen I/III ratio increased in the same samples by week 12 (p?<?0.05, and p?<?0.0001, respectively), in keeping with normal scar formation. Optical coherence tomography attenuation coefficient representing collagen deposition was significantly decreased at week 4 compared with day 0 and increased at week 16 (p?<?0.05).Innovation: This study provides a platform for further research on the simultaneous evaluation of the effects of compounds in cutaneous scarring by RS and HPLC, and identifies a role for RS in the therapeutic evaluation and theranostic management of skin scarring.Conclusions: RS can provide noninvasive information on the effects of topicals on scar pathogenesis and structural composition, validated by other analytical techniques.

摘要：This study explored the effects of Moist Exposed Burn Ointment (MEBO) on the healing process of pressure-induced wounds. Using a stage IV pressure ulcer model established in 42 rats, divided equally into a control gel group and an MEBO group, we investigated the efficacy of MEBO through topical application. The control group received Carbomer gel, while the MEBO group was treated with MEBO until complete wound healing. Results showed that MEBO significantly accelerated wound healing compared to the control group. Histological analysis, including hematoxylin and eosin (HE) staining and Masson’s trichrome staining, revealed enhanced epithelialization and collagen deposition in the MEBO group. Furthermore, 16S rRNA sequencing indicated that MEBO reduced microbial diversity at the wound site and reshaped the microbial composition. Notably, The increased abundance of Acinetobacter and Staphylococcus, coupled with a reduction in Pseudomonas, may reflect a shift in the wound microbiome that could be conducive to healing. However, the exact role of these microbial shifts in promoting wound healing requires further investigation, as microbial dynamics in wound environments are complex and context-dependent. These findings suggest that MEBO facilitates wound healing by optimizing the wound microbiome, thereby offering a promising therapeutic approach for managing pressure ulcers.