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  • Clinical Analysis of 203 Cases of Multi--microorganism Septicemia in Burn Patients


    Zhang Hong Gao Zengshou

    (The 159th Hosnital, PLA. Zhumadian)

    203 burn patients with multi--microorganism septicemia were treated in our hospital from 1981 to 1992. The cases accounted for 39.88% of the total number of burn patients in the period. The mortality was 47.78%. Multi--microorganism septicemia was a main class of burn septicemia. The inducing causes and the prognosis of the septicemia were analyzed and the precautions in the treatment were discussed.

    A Whole--body View on and Countermeasures for Acute Fever of Burn


    Zhang Xiangqing Zhang Ling

    (No. 139 Hospital, North S.handong Burn Centre)

    A discussion on the biological significance of burn fever and countermeasures was made.

    1. The biological significance of body temperature regulation and fever. The relationship between the regulatory actions of sympathetic, parasympathetic nerves and nerve centre (hypothalamus )is described.

    2. Treating burn fever with a view of equilibrium medicine.

    According to the principle of equilibrium regulation, no treatment is necessary for fever below 39C. Patients with fever exceeding 39C should be treated with psytic measures including physical and medicinal methods. Physical methods are of first choice. Antipyretic drugs act mainly on thermoregulatory centre and may have some side effects. Glucocorticosteroids may be useful but the mechanism of the action is not yet very clear. Abuse of glucocorticosteroids may result in serious consequences.

    Clinical Research on Medium Molecular Weight Dextran for Blood Volume Expansion in Treating Burn Shock Ⅱ

    --The Effect of Excessive infusion of Medium Molecular Weight Dextran on the Recovery of Edema


    Wang Dechang, et al.

    (Dept. of Burn Plastic Surgery, Shandong Provincial Hospital)

    It has been proved that excessive infusion of medium molecular weight dextran may interfere with blood grouping test, blood coagulation mechanism and endothelial system function, prolong bleeding time and increase the tendency of bleeding or result in renal insufficiency. The effect of excessive infusion of mediUm molecular weight dextran on the recovery of edema is not yet very clear. This paper reports 92 cases of exceptionally severe burn treated with infusion of medium molecular weight dextran. Patients in the first group were infused with no more than 1,500 ml of the dextran and those in the second group more than 1, 500ml. The time for the recovery of edema was remarkably prolonged in the group of patients receiving excessive infusion of the dextran. The authors analyzed the causes of the prolongation of the recovery of edema and concluded that 1. the dextran with an average molecular weight of 70, 000 varies largely in molecular weight of individual molecules. Dextran with larger molecular weight is difficult to be absorbed when coming out of the vessel and 2. the dextran binds more strongly with water than with protein.

    The Role of Phospholipase AZ in the Pathogenesis of

    Postburn Multiple System Organ Failure


    Luo Jian Ma Enqing

    (Department of Burn and Plastic SurserV, XianHYa Hosoltal, Hunan Medical University)

    Phospholipase A2(PLA2) activation represents a rate -- limiting step in the synthesis of platelet avtivating factor, Ieukotrienes and prostaglondins, and it is also associated with lipid peroxidation. Under the condition of hypoxia, ischemia, shock and invasion of endotoxin, PLA2 is activated and can lead to organ failure by producing membrane lysis and cellular injury either through a direct action of itself or through indirect actions of its products. PLAZ has been demonstrated to play an important role in the pathogenesis of multiple system organ failume. after burn and trauma. PLA2 inhibitors may be valuable therapeutic agents of multiple system organ failure.

    Experimental Morphological Study on Microcirculatory

    VascularTree of Skin (7)


    Bat Shuting Li Ji

    (China Medical University)

    We studied the microvascular architecture features of fetus thenar of 6 month age, using the method of indian ink injection and optical microscopic observation and by ABS vascular cast and AEM observation.

    We found that the Cutaneous vessels in papillary layer of fetus skin didnQt form, at this stage. Only a little of vascular embryonic form, in dermis papillae, was formed in fornix type.

    The subpapillary networks were very tense in fetus. The examination with image analysis system for 127 vascular networks showed that the area was 814. 321 561. 02urn2;the diameter of the network hole was 44. 20117. 80 urn lthe width was 25.79+9.38um. The embryo of the blood vessels in deep dermis, in fst layers and in deep fascia could also be seen clearly. The theoretical significance and the clinical value were discussed based on the morp-hoiogicai characteristics of the vascular architecture.

    Burn Granulation Wounds Healed by MEBO


    Long Jianhong Ma Enqing Liu Fazhu

    (Dept. of Burn Plastic surgery, xlanya Hospital, nunan -

    Medical University)

    14 burn patients were treated with MEBT and 14 with non -- MEBT Clinical and pathological observations were made. Under optical microscope, in MEBT group, collagenous fibers in the granulation wounds were in clusters and parallel arrangement with regularity. Fibroblast count was much fewer than that in the non --MEBT group (P<0.05). Capillary count was a little more than that in the non --MEBT group,but the difference had no Statistical significance. These results implied that MEBO had regulating effect on the formation, division and proliferation of the fibroblast and the secretion and arrangement of the collagenoUs fibers. The results of the examinations on the PH value of the granulation wounds, surviving rate of the skin graft and wound culture showed that the effect of MEBT was better than non--MEBT.

    A Discussion on Three Clinical Problems Concerning Burn Wounds


    Hong Sitong Liu yuman

    (General nospital of Beuxi iron and steel corporation)

    There are three problems on the mind of the ciinicians concerning burn wounds.1. How to diagnose the depth of the wound? 2. What is favorable to wound healing? and 3. How to select and ideal drug for treating burn wounds?

    Modern technique such as B--mode ultrasonic imaging method can be used to detect the depth of the wound, but t.his technique is not yet popularized. The presence of bacteria on the wound may be favorable to epithelialization, but bacteria infection is always a risk.

    The application of MEBO .can solve these problems. MEBO makes possible for clinicians to have a dynamic observation on wound depth. It inhibits bacteria growth therefore gets rid of the danger of septicemia. It promotes epithelialization by making the wound vitalized in a nonaqueous, lipoid environment. MEBT and MEBO would have more vitality and a more glorious future when combined with the application of new high technique of modern medicine.

    The Characteristics of Relatively Low Temperature Burn and its Early Treatment


    Zhu Xiaoqin Chen Guoqing

    (Dept. of Burn Plastic Surgery, People's Hospital Maanshau City)

    The characteristics of relatively low temperature burn were analyzed to be as follows :

    1. Temporary sensory or conscious disturbance.

    2. Burned by a relatively low temperature but for a long time.

    3. Deep wounds.

    4. Third degree burns have vesicles and are easy to be misdiagnosed as second degree burns.

    5. With profuse vesicle fluid and large amount of heat.

    Its early treatment includes:

    1. Removal of all the vesicles.

    2. Active cooling therapy.

    3. Inspection of deep tissue injury and expecting healing by first intention.

    Experience in Treating 1217 Cases of Burn with MEBT


    Qiao Haibin, et al.

    (Child--Welfare Hospital, Nehe City, Heilongjiang Province).

    1217 cases of burn were treated with MEBT and MEBO. The largest burn area was 7.5% and the smallest 2%. All had second and third degree burns. The healing rate was 100%. The treatment was carried out properly under the guide to MEBT, with respect to different depth of the wounds. For large area burns attention was paid to systemic treatment, especially to antishock nutrition support and preventive measures and nursing.

    Clinical Analysis of 156 Cases of Burn Treated with MEBT


    Hong Jianjun

    (Lanxi Hospital of TCM, Zhejiang Province)

    The author treated 156 cases of different kinds of burns using MEBT. The healing rate was 100%. The application of MEBT and MEBO possesses the following merits: Stopping pain quickly, good preventing and countering infection effect, short healing time, no scar or less scar formation. It is Suitable to be pgpularized in grass--root medical units and firebriaades.

    Experience in Treating 160 Cases of Head and Face Burn with MEBT


    Wang Yan fen, et al.

    (Burn Branch, The sib People's Hospital, Harbin)

    160 Cases of head and face burns were treated with MEBT. The results were very satisfactory. None of the patient had infection and none had been subjected to skin grafting. Only one case with 3rd degree burn wounds had scar formation but was healed without leaving any scar after continuous application of MEBO for 2 months.

    A discussion on the mechanism and the advantages of MEBT for treating head and face burns was made.

    Analysis of 104 Cases of Chemical Burn of Eyes Treated with MEBO


    Wang Jiahe Kong Jin

    (Dept. of Burns, The 3rd People's Hospital, Xuzhou City)

    Face and eye burns when treated witl conventional method often result in disfigurement, This paper reports 104 cases of face burn treated witl MEBO. Among which 31 cases were complicated by eye burns. All the patients healed satisfactorily, except for one who had eyeball enucleated because of eyeball perforation and vitreous body profluens caused by caustic soda burn.

    MEBT for Treating Large Area Deep Burn Wounds


    Zhou Zhongquan, et al.

    A pregnant woman was burned and fell to the ground from the 2nd floor of the building. The patient was in a state of coma for half an hour before she was sent to the hospital. She was dignosed to be burned by flame and had a total burn area of 85% BSA. 79% of the burn was 3rd degree burn and complicated by inhalation injury. Upon hospitalization, she received infusion with colloid: crystalloid= 1: 1, according to Evan's formula. 11 hours after burn, the dead baby was delivered. The wounds were treated with MEBT. Lower limbs were treated with Ag--SD ointment while upper limbs and trunk were treated with MEBO. Lower limbs were found soon to be infected and MEBO was used instead of Ag--SD. Skin grafting was carried out 3 times in 5 months. The patient healed.

    Treatment of 86 Cases of Electric Burn


    Tao Yexing, et al.

    (Dept. of Burn Plastic Surgery, Xinjiang People's Hospital)

    Electric burn may be very serious and complicated and often result in disastrous consequences. 86 electric burn patients were treated and cured in our hospital from January 1977 to March 1992, accounting for 3.1% of all burn cases in that period. Key points of the prevention and treatment of electric burn shock, management of burn surface, amputation. and effective measures for secondary bleeding on burn area were discussed.

    Experience in Treating 32 Cases of Chemical Burn Using.

    MEBT and Drug and Knife Combination,I Technique


    Chen Congchao

    (People's Hospital, Jiaojiang City, Zhejiang Province)

    This paper reports the experience in treating 32 cases of chemical burn using MEBT and 11 drug and knife combinationll technique. The results was very satisfactory. The author concluded that this technique has its advantages of preventing further injury of the chemicals and lessening progresssive damage of the wound tissue. No skin grafting was needed for Znd degree wounds. For 3rd degree wounds, the skin grafting area was reduced.

    A Comparative Study of Dry and Moist Therapy for. Treating Face Burns


    Tan Qingyan, et al.

    (Dept. of Burns, Central Hospital, Qilu Petrochemical Co. )

    90 caseS of facial burn were treated with dry therapy and another go caexes treated with moist therapy. All the patients healed. A comparison of the f results was made and the authors concluded that moist therapy had stronger antiinfective and analgeaie effects. The healing course was shortened. Scar formation and disfigurement were prevented and had a good appearence. Therefore moist therapy is superior to dry therapy.

    Perioperation Period Treatment of 220 Cases of Pediatric Burn


    Qi Shunzheu Qi Xiaoqing Liu Jianchun Sup Zhigang Zany Shuyin

    (Dept. of Burns and Dept. of Anesthesiology, International Peace Hospital)

    Pediatric burn accounts for 1/3 to 1/2 of the total burn victims. The mortality of burn children is higher than that of the adults. Most of the death occur at the perioperation period. Therefore, perioperation treatment is very important in saving the life of the children. The authors treated 498 cases of podiatric burn in the past few years. 220 of them received surgical operationsl accounting for 44. 18% of the total. The average age of the operation group was 4.614. 1 yearns (3 months to 11 years). Among the 220 children who received dperation, 27 children received plastic surgery, 20 amputation (finger and/or toe), 47 escharotomy and skin grafting, .153 nibbling escharotomy and/or granulation wound skin grafting and 210 received ketamine intravenous anesthesia (88.64% of the total). Intravenous administration of ketamine had the advantage of rapid waking after operation and the dose could be controlled at any time during the course of the operation. When blood loss exceeded 15%, blood transfusion was needed. 61 cases received modified free small skin grafting. The Survival rate of the skin graft was very high. Parents were advised to be the skin donor for the children with large area deep burns. After operation, attention was paid to the prevention and treatment of complications, fever and convulsions. The experience in the inspection of the condition of the patients and their venous pathway and the .nursing of the wounds in different parts of the body was described in detail.

    The Application of MEBO in Traumatic Surgery


    Niu Zhiliang

    (Dept. of Hemorrhoid and Fistula and Burn ,Yuanqu County Hospital, Shanxi Province)

    120 cases of trauma were treated with MEBO. None of the patients had infections. MEBO had good analgesic effect. It promoted adequate drainage and facilitated removal of necrotic tissue and granulation. It protected the wounds and had good antiinfective power. MEBO is a good drug for traumatic injuries.

    Clinical Experience with MEBO in Treating Deep Abscess


    Qi Ruhua

    (Wuhe County H6spital, Anhui Province)

    The author has treated more than 200 cases of deep abscess with MEBO since April 1991. MEBT or any other change of dressings were satisfactory. For treating 11 caacs of deep abdominal abscess, perfussion method was superior to other conventional method of dressing change. It is simple, economical and time saving. It has good drainage, analgesic and antiinfective effects. It is worthy to be popularized.

    Experience in Treating 32 Cases of Decubital Ulcer with MEBO


    Liu Jian Qin Weiltua

    (Dept. of Orthopedics, People's Hospital, Linfen Prefecture,

    Shanxi Province)

    32 cases of decubital ulcers were treated with MEBO. The results were very satisfactory. Most of the 3rd and 4th degree decubital ulcers healed in 45 days. When MEBO was applied onto the wounds, a series of physical and chemical changes took place. As a consequence, the immunity and antiinfective power of the local tissue was enhanced. Microcirculati.on of 'the tissue around the wound was improved. Granulation and skin island formation were accelerated. The wounds healed without formation of scar, or with only very thin scar. The application of MEBO is very easy and simple and is not painful and therefore it is widely accepted by the patients.

    20 Cases of Lower Limb Chronic Ulcer Treated with MEBO


    Yang Hechai

    (Hospital of Traditional, Chinese Medicine, Tianiin)

    20 cases of lower limb chronic ulcer were treated with MEBO and 10 cases were treated with a traditional Chinese Medicine called Myogenic Adhesive Plaster. A comparison between the therapeutic effects of the two drugs was made. The results revealed that MEBO was superior to Myoaenic Adhesive Plaster. MEBO had stronger heat clearing, detoxifying, swelling subsiding, analgesic, necrotic tissue removing, granulation promoting, blood circulation promoting and.antiinfective effects than Myogenic Adhesive Plaster.

    MEBO for Treating 38 Cases of Wound After Exclusion of

    Adherent Prepuce with Balanus of Children


    Miao Qilong, et al.

    (Dept. of Urology, the 3rd Hospital of Ningbo)

    The authors used Oculentum Chlortetracyclini and MEBO respectively for treating wounds after exclusion of adherent prepuce with balanus of children and analyzed their efficacy during 1987 to 1993. The results proved that MEBO is superior to Oculentum Chlortetracyclini in wound healing time and analgesic effect. Besides, MEBO has powerful effect of preventing infections and has no side effect.

    Clinical Observation and Nursing of Burn Wounds

    Treated with MEBT


    Cul Shuhua, et al.

    (Dept. of Burn Plastic Surgery, Affiliated Hospital of

    Binzhou Medical College, Shandong Province)

    542 cases of burn were treated with MEBT. The experience in the observation and nUrslne of the wounds are summarized.

    1. Observption and nursing of the wounds.

    Burns of different kinds had different wounds. Scalds had moist wounds, thermal injury had dry wounds and oil burns had smoky dark wound.Shallow wounds had profuse exudatp at the early stage and the swellings subside quickly. Deep wound had little exudate and the swellings subsida slowly.The frequency of the application of MEBO should be different at different stages. For 3rd degree wounds, a # shape incision or escharotomy using a rolling dermatome is recommended, this treatment will help ,shorten the healing time of the wounds.

    2.Observation and nursing of erosion wounds.

    Attention shuld be paid to observation of the systemic and local changes.

    3. Nursing at the f stage of recovery.

    Attention should be paid to protection of the epithelia and skin islands and the occurrence of folliculitis should be prevented.

    Psychological Nursing of 60 Patients with . Different Wounds.


    Bat Skufen

    (General Hospital, China Railway Consttuctlon Corporation)


    This paper reports the psychological nursing experience in treating 60 patients with different kinds of wounds including burn, scald, electric injury, decubital ulcer and refractory wounds.

    When these patients were hospitalized, they had more or less a feeling of nervousness, fear, anxiousness, dysphoria and loneliness. Such a feeling will affect the efficacy of the treatment and may result in complications. Psychological nursing was done to eliminate nervous felling and fear and to make the patients cooperative in the treatment. While applying MEBO onto the wounds, it was necessary to divert the patient's attention and make the patients relaxed. A cordial conversation using a mild tone would be very useful to make the patients feel warm and have confidence in the doctor and the nurse. Patients of different ages would have different psychological problems and could only be solved by different methods. Supports from the family and the society were also necessary in order to lessen the psychological load of the patient. It was very important to help the patient to adopt a correct attitude toward the disease and be realistic to fight against the disease.

    Psychological Nursing of Patients with Head and 'Face Burns


    Song Jinge

    (Dept. of Burn Plastic Surgery, The Znd Hospital, Yanzhou' Mining Bureau)

    This paper reports the psychological nursing experience in treating 108 cases of head and face burns. The author concluded that the psychological changes of the patient are closely correlated with the condition of the burn injury, sex, age and family and social status of the patient. The nursing should be taken according to the different cases. Understanding of the intrapsychological world of the patient is the key to the nursing work.