摘要：Cutaneous delayed wounds are a challenging clinical problem, and vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) exhibit key roles in wound healing. Moist exposed burn ointment (MEBO), a Chinese burn ointment with a USA patented formulation, has been reported to promote chronic ischemic and neurogenic ulcer healing in patients; however, the underlying mechanisms remain unclear. In the present study, MEBO significantly promoted the formation of granulation tissue in cutaneous excisional wounds, shortened the time of wound healing, and increased neovascularization and the number of fibroblasts. Furthermore, as well as enhancing the protein expression, MEBO application also increased the gene expression of VEGF and bFGF. The results indicate that MEBO promotes cutaneous excisional wound healing by at least partially enhancing VEGF and bFGF production, implicating the potential uses of MEBO for delayed cutaneous wound healing.

摘要：Background: The incidence of diabetes-related wounds is widespread, and the treatment is challenging. We found that Moist Exposed Burn Ointment (MEBO) promotes the healing of diabetes-related wounds, but the mechanism is not clear.Methods: This study aimed to explore the mechanism of MEBO on diabetic wound healing, which may be related to the promotion of re-epithelialization. A full-thickness skin resection model was established in streptozotocin(STZ)-induced diabetic mice. MEBO and Kangfuxin (KFX) were applied to the wound area, and the wound healing rate was analyzed by photographing. The granulation tissue and epidermal thickness, the collagen remodeling rate, and the expression of cytokeratin 10 (CK10), cytokeratin 14 (CK14), Ki67,CollagenⅠ,and Collagen Ⅲ in the regenerated skin were detected by H&E staining, Masson staining, and immunofluorescence staining, respectively. MEBO and KFX were applied to human immortalized keratinocytes (HaCaT)、mouse dermal fibrolasts (MDF) cells, and cell viability, cell migration, and differentiation were determined by CCK-8, scratching assay, RT-qPCR, and Western blot(WB), respectively. Results: We found that MEBO significantly promoted the formation of wound granulation tissue and collagen remodeling in diabetic mice. The application of MEBO to diabetic wounds not only promoted the formation of hair follicles and sebaceous glands but also promoted the expression of Ki67, CK10, and CK14 in epidermal cells. MEBO had no significant effect on the differentiation process of keratinocytes.Conclusions: Our study further proved that MEBO plays a positive role in diabetic wound healing, and its excellent ability to promote re-epithelialization may be an important reason for promoting wound healing.

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：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.