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Clinical Summary for Treatment of Patients with Severe Burns with In-site Skin Regeneration Medical Techniques and MEBO
Add Timeㄩ2014/1/2 17:13:27
Clinical Summary for Treatment of Patients with Severe Burns with In-site Skin Regeneration Medical Techniques and MEBO
Chen Shiping and Xue Wenxiong with First Hospital of Yulin City of Shannxi Province
In recent years, we have admitted patients with severe burns and treated them with in-situ skin regeneration medical technology and MEBT/MEBO. The therapy is easy to handle and the efficacy is obvious. Through standard treatment, the patients can stably go through shock phase with better treatment results. Now, I would like to detail the treatment process and clinical experiences as follows:
Clinical Information:
Altogether, we have admitted 159 patients with severe burns, among whom, 93 were males and 66 were females, aging from 5 to 63 years old. The smallest burns area was 10%TBSA and the largest one was 84%TBSA. The full-thickness burns accounted for 50% and 22 patients complicated with shocks, 6 cases complicated with inhalation injuries.
Treatment Methods
Rescue Treatment 每 Medical staff shall arrange the patients into burns ward as soon as possible. The room temperature shall be kept between 30 to 32 degrees. The body turning bed shall be used and the infrared light shall be used for keeping warm and oxygen inhalation. In addition, conditions of patients, including history of shocks and complications and dyspnea and inhalation injuries, shall be understood to maintain smooth air way.
Treatment against Shocks 每 After being admitted, one to two intravenous channels shall be established by nurses for patients. The crystal liquid shall be first transfused, the urine catheter shall be used and the urine volume, PH value, urine specific gravity and whether there are symptoms of hematuresis and hemoglobinuria shall be recorded. The type of blood, urine routine, hematocrit of red cells, electrolytes, kidney functions and blood sugar shall be examined. The burns area and depth shall be estimated. The rescue scheme and the fluid supplement plan for the first 24 hours shall be worked out and the MEBO shall be used to prevent evaporation of water. Patients with symptoms of shocks can be treated based on MEBT/MEBO formula about fluid supplement. The urine volume shall be regarded as reference index, the urine volume for adults shall be kept between 60ml/hour to 80ml/hour, and the same figure for children shall be 40ml/hour to 60ml/hour, the proportion of crystal and glue shall be 1:1, the transfusion of crystal and glue shall be done alternatively.
Treatment against Infections 每 The principle of treatment against infections shall focus on the sufficient supply of broad-spectrum antibiotics at early stage. Seven to ten days later, the antibiotics shall be terminated when wounds enter into summit phase of liquefactions. The whole course of treatment against infections shall be based on whether the toxic granulations can be observed in neutrophile granulocytes. The antibiotics shall be adopted for once targeting at the focus, and the third-generation cephalosporins shall be the top choice and the administration shall be regulated according to bacteria culture on wounds and the results of drug sensitivity test.
Nutrition Support 每 Total parenteral nutrition shall be supplied according to conditions of patients. Suitable amount of protein, fat emulsion, whole blood and plasma shall be provided according to areas of burns. The patients shall be encouraged to take food to maintain nutrition of gastrointestinal tract. While maintaining gastrointestinal functions, diet featuring fresh and flow food with high nutrition shall be provided regularly with short intervals.
Prevention of Complications 每 For all patients with severe burns, tetanus antitoxins shall be infused through muscle injections to ensure smooth airway. Among all 159 patients in this group, six were observed with burnt nasal air, urgent breathing and coarse voice. At the same time, they were all suffering from burns on head and face. Apart from one patient died from suffocation at early stage of severe inhalation injuries, the rest five accepted tracheotomy before wound debridement while receiving treatment against shocks. Routine oxygen inhalation and supersonic nebulizer shall be adopted and the vasoactive agents shall be used to maintain heart and kidney functions. At early stage, cardiac treatment shall be adopted to protect functions of heart and kidney. The diuretic mixture that can expand vessel of kidney and improve flow of renal blood in order to protect kidney functions. At the same time, the screening functions of gastrointestinal mucosa shall be protected during the course of treatment, thus preventing irritable ulcers complicated with hemorrhage of digestive tract.
Treatment of Wounds 每 Debridement shall be done at early stage right after the symptoms of shock turn stable. However, the wounds shall be well protected before debridement. The burns with smaller area usually enjoy less serious infections and require no debridement, and MEBO can be directly smeared onto wounds with a thickness of 1mm three times a day. The thickness of MEBO smeared onto full-thickness burns shall be 1.5mm to facilitate dissolving and shedding-off of scars. Before smearing each time, the secretions on wounds shall be cleansed before drying the wounds with cotton swab, which is good to long-lasting and smooth drainage on wounds. MEBO can change the environment for the growth and reproduction of bacteria, preventing the sepsis caused by the rejection reactions of wounds in summit phase. As for the partial-thickness and full-thickness wounds, the methods adopting medicine and knife or ploughing shall be selected to remove necrotic tissues when smearing MEBO onto wounds in order to make survived tissues contact drugs as soon as possible and to give play the efficacy, speed up liquefaction speed of wound, shorten disease course and prevent wound infections and sepsis. The necrotic tissues shall be removed based on the principle of preventing no further pains, further bleeding and no further damaging of surrounding tissues.
Treatment Results
Apart from 2 patients who have died, all the rest received sound results, with 98.7% healing rate. Among all of them, 20 patients with shocks passed shock phase stably, without suffering any complications. Five patients of all of them with inhalation injuries received tracheotomy surgery featuring lavage and nebulizers, without suffocations and other complications. Twelve patients suffer from wound infections of different degrees. Then, the wounds stopped deteriorating and no complications and dysfunctions of multiple organs occurred due to MEBT/MEBO therapy and ploughing treatment.
Clinical Discussions
Treatment of Shocks at Early Stage 每 This is the base of successful rescue and the proper treatment measures shall be regarded as the fundamental elements for the whole course treatment and prognosis of patients. At first, two to three intravenous channels shall be rapidly established. The first one is transfusion of glue liquid crystal through different channels, facilitating temporary administration through veins. The second one is rapid supplement of fluid to correct shocks and to provide better conditions for the following treatments and to facilitate going through dangerous phases stably.
Anti-infection Treatment 每 Infection is still a critical cause of death among patients with severe burns. Such patients were administered with third-generation cephalosporins which shall be terminated after one week. At early stage, powerful antibiotics shall be used with a purpose to enhance the effective density on wounds in secretion phase. What is worth mentioning is administration shall be done based on culture of bacteria.
Treatment for Inhalation Injuries 每 Inhalation injury is one of the key causes of death among burn patients, and laryngeal edema is the most common elements. Patients with mild inhalation injuries shall receive tracheotomy while being treating with measures such as humidifying and washing of airway, thus greatly reducing risks of complications of lung.
Enhancing Nutrition and Immune System 每 For patients with severe conditions, the methods of total parenteral nutrition shall be shifted to that of gastrointestinal nutrition. The concept of taking less fresh and easily digestive food with more intervals shall be taken in order to ensure gastrointestinal functions and immunity of body.
Prevention of Complications 每 Prevention shall prevail for dynamic observation and prompt handling. If necessary, phentolamine, cedilanid and oxygen free radical scavenger shall be used as early as possible to maintain heart functions. Nebulizers and oxygen supplying devices shall be used to ensure smooth airway and maintenance of pulmonary functions. After the effective resuscitation, diuretic mixture, dopamine and sodium bicarbonate shall be used at early stage to prevent renal insufficiency. In addition, cimetidine shall be used to prevent massive haemorrhage of digestive tracts.
Treatment of Wounds 每 During treatment, the wounds shall be always kept moist and the semi-viable tissues shall be maintained. MEBO can prevent evaporation of water on wounds, stop pains and drain necrotic tissues, secretions and metabolic products. The semi-viable tissues can be restored after burns and shall not be completely removed. The wounds shall be kept in moist environment to ensure self restoration of wound tissues. MEBO can effectively isolate wound with bacteria from outside and protect burnt tissues. MEBO can also drain damaged tissues and secretions on wounds to maintain smooth drainage, thus effectively destroying reproduction environment of bacteria and infection by bacteria.
Treatment of Psychological Rehabilitation 每 Patients will usually present psychogenic metal disorders, featuring fear and extreme tension followed by anxiety, depression and nervous breakdown and making rescue difficult. During treatment, psychological implication shall be made and the severity of disease shall be made clear to facilitate treatment. Patients shall be told the hope of successful treatment to get rid of fear and enhance its awareness of survival. If necessary, medical treatment shall be supplied.
Clinical experiences show that in-situ skin regeneration medical technique and MEBO wound ointment can easily save patients with severe burns, the methods are simple and free from side effects. It can satisfactorily stop pains. The correct use of it can realize high rate of healing, short treatment course and low cost with its easy and simple operation.

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