目录

The Position of Ischemia/Reperfusion injury in Burn Pathology

(Abstract)

Zhang Xiangqing

(No. 139 Hosoital, PLA)

lschemia and hypoxia of the tissue is an important pathological change at the early stage of severe burn. Fluid resuscitation and normalization of )issue oxygen partial pressure have been recognized as a principle of the treatment. However, according to recent concept of ischemia/reperfusion injury, tissue injury does not occur at the ischemic and hypoxic stage, but occurs after reperfusion. This gives rise to a practical problem in clinical treatment. The author considers burn as the cause of ischemia/reperfusion injury. At the stage of ischemia and hypoxia, the tissue has already had the substrate which procures oxygen derived free radical (ODFR ), and the enzyme (xanthineoxidase) which catalyzes the production of ODFR by this substrate. At the beginning of the hypoxia stage, no excessive production of ODFR occurs, once the oxygen supply is resumed, the production of ODFR is accelerated. Cells of various tissues are injured at this stage. So that oxygen J supply can be considered as the "trigger" shooting out ODFR. Therefore, shortening the period and f I lightening the seventy of ischemia and hypoxia and timely application of fluid resuscitation can diminish t Ithe production of ODFR. At the same time, application of antioxidant can diminish the injury caused by ODFR.

Clinical Application and Analysis of Renal Radio--immuno Examination in Severe Burns

(Abstract)

Feng Yuzhu Dong Yunfeng Yang Xianwen Zhang Qingao

(Dept. of Burn Plastic Surgery, Workers' Hospital and Research Center of Burns, Tangshan City)

Renal radio--immuno examinations of 52 cases of burn (30 to 90% BSA, 0 to 66% third degree burn) were made. Renal function at different time phases were analyzed on the basis of the results of the examination on 7 criteria. The results were Summarized as follows: 1. Blood 8, microglobulin content increased at different time phases. 2. Urine albumin content' increased at 2 weeks postburn. 3. Blood lgG decreased at 2 weeks postburn. 4. Urine IgG excretion increased postburn. 5. Blood THP level kept normal at different time phases. 6. Urine THP leyel increased at 2 weeks postburn and 7. Patients with third degree burn area exceeding 50% BSA had THP level markedly increased.

Statistical analysis showed that increases in blood gi microglobulin and blood THP and decrease in blood lgG level had significant correlations with the mortality. These criteria are of clinical significance in prognosis of severe burn patients.

Treatment of Burns, Wounds and Ulcers Based on an Overall Analysis of Symptoms and Signs

(Abstract)

Song Yuehua, et al

(No. 139 Hospital)

In recent years, we used MEBO and MEBT in the treatment of burns, wounds and ulcers and achieved good results. In this paper, we will discuss the overall analysis of symptoms and signs in the treatment. 1. Etiology: They can be classified as thermal injury, wounds and ulcers. 2. Overall analysis of symptoms and signs based on the study of pathological changes in the viscera, qi, blood and body fluid, in accordance with the principle of four diagnostic methods and eight principal syndromes, Pay attention to local treatment and at the same time, to the internal condition of the body, to see if there is excessive fire impairing yin, deficiency of yin affecting yang and noxious heat in the heart, 'lung, liver I spleen or kidney, etc.

3. The principles of the treatment of burns, wounds and ulcers include resolving and expelling from within and reinforcement and can be further divided into (1 ) relieving exterior syndrome, (2 ) activating interior function, (3) heat clearing, (4) warming the channel to promote the flow of qi, (5) removing the dampness, (6) dissipating the stasis, (7) resolving the ulcer and (8) tonifying mathod.

Experience with MEBT for Treating Large Area Burns

(Abstract)

Xiao Xinmin

(No. 364 Hospital)

80 cases of large area burn were treated with MEBT and 40 cases were treated with dry exposed therapg. Comparison of the results of the two methods revealed that: MEBT and dry exposed therapy had a healing rate of 89. 7% and 85% respectively (P>0. 05). The difference had no statistical significance. In MEBT group, Hb and Ht values were relatively more , stable but plasma protein level lowered more markedly. The incidence of stress upper digestive tract hemorrhage in MEBT group was 7. 5%, lower t than that of the dry exposed therapy group (17.5%) (P< 0. 01 ). The difference was of statistical significance. Skin grafting and wound deepening rate of deep second degree burns were respectively 23. 0% and 10. 8% in MEBT group and were respectively 62.8% and 40.0% in the dry exposed it therapy group (P<O. 01).

The effects of MEBT in treating and preventing shock and infection were discussed. An analysis of the reasons of the failure in MEBT treatment was made. The author emphasized that in the application of MEBT, patients should be ensured to pass the shock stage smoothly. Pay attention to systemic treatment and properly grasp the key points, e. g. uniform smearing of MEBO, keeping the wounds moist, timely debriedement, keeping the wounds thoroughly exposed and proper use of a combination o f drug and knife technique. Make full play of the four main effects of MEBO, i. e. quick diSsolution of the scab, active drainage, covering the wounds and regeneration of the epithelium 9 to provide a favorable condition fot the recovery of burn Wounds.

13 cases had burn area larger than 70%BSA. 10 of them healed. The healing rate was 90.9%. The average healing time was 25 days.

Experience in Successful Rescue of a Case of Electric injury complicated by Fragmentation of Larynx an4 Trachea and Rupture of Carotis Communis

(Abstract)

Lu Xuemei

(People's Hospital, Liaocheng Prefecture, Skandong Province)

This paper reports the experience in successful rescue of a case or severe electric injury complicated by fragmentation of larynx and trachea and rupture of carotis communis using MEBT.

Our experience is summarized as follows:

1. Ensuring the respiratory tract unobstructed.

2. Bleedings completely stopped.

3. Keeping effective blood volume.

4. When MEBO was used in conjunction with surgical treatment, the therapeutic course was shortened.

Clinical Use of MEBO with Bandaging Method

(Abstract)

Kang Yunfeng Meng Wei

(Dept. of Surgery, Hospital of integrated Chinese and Western Medicine, Beijing Urban Construction Bureau)

40 burn patients were treated with MEBO using bandaging method. The results were satisfactory.

Typical cases including their sex, age, burn area and distribution were described. The authors concluded that MEBO bandaging method had the advantages of quick healing, no scar formation, no pain, easy nuraing, good recovery of the function and no tendency to infection.

The Application of Drug and Knife Combination Technique of MEBT in Treating Large Area Third Degree Burn Wounds

(Abstract)

Yang Kefei Guo Zhengchun Li Ping

(Medical Team of Fire Fighting Brigade, Shenvans City)

14 patients with third degree burn were treated With MEBT using drug and knife combination technique. 10 patients healed and 4 died. The results are summarized as follows:

l. In addition to proper use of drug and knife combination technique, comprehensive treatment is necessary including antishpck measures at the early stage, supporting measures and rational application of antibiotics at the later stage and strict sterilization and isolation.

2. Early use of the drug and knife combination technique and early debriedement.

3. In application of the combination technique, take care to ensure no narcosis, no pain, no bleeding and no injury of the parabiotic and healthy tissue.

4. Attention points: (1 ) constant room temperature, (2)keeping the wounds clean, (3) using turn--over bed and (4) analysis of thecause of burn.

Body Temperature Rise After Using MEBO in the Treatment of Burn

(Abstract)

Sea Guangxin

(Medical Centre, Xuanwu Chinese Medicine Hospital, Beljibg)

919 cases of burn were treated with MEBO. 185 of therm had a burn area of more than 30%BSA. Patients with deep second degree burns had body temperature .aide after application of MEBO at the early sts=ge, It is considered as a normal ;phenomenon, if the fever did not exceed 39C. A high body temperature would be bgoeficial to the clients, because,MEBO can give a better therapeutic effect, the revitalization of the stasis zone tissue can be promoted and the decomposition of necrotic tissue and blood circulation can be accelerated, local capillary embolism can be reduced, tissue granulation and epithelium regeneration can be accelerated. In a word, a rise of body temperature after the applicatiion of MEBO has its advantages over its disadvantages.

The Relationship Between Drug Therapeutic Effect and Time of Hospitalization of Burn Patients

(Abstract)

Li Fengchun Meng Chonglian Zhou Xia

(No. 322 Hospital, PLA)

Skin and mucous membrane are affected postburn. Lesions of the epidermal and epithelial cells and exudation of body fluid result in further dehydration and necrosis of the tissue cells and deepening and broadening of thelwounds. MEBO can solve the problems satiisfactorily. Early hospitalization : and timely application of MEBQ is the key point in burn treatment. It is beneficial to the survival of the stasis zone tissue. In this paper, the authors report the results of two groups of patients. Patients in the first group hospitalized within 24 hours postburn and those in the second group hospitalized after 24 hours postburn. The difference had statistical significance, The authors conclude that patients should be sent to hospital as quickly as possible and be treated immediately with MEBO upon hospitalization.

Nursing Experience with MEBO for Treating Burn of Special Parts of the Body

(Abstract)

Han Quanfu, et al

(Hospital for staff and Workers Organic Chemical Factory, Jingmen City, Hubei Province)

200 cases of burn were treated with MEBO. 64 of them had burns of special parts of the body which included head, face, respiratory tract, perineum, etc. Nursing experience is summarized as follows:

1. Nursing of the eyes: MEBO should be.smeared onto the eyes and MEBO ribbon gauze be used to protect the eyes, In order to prevent conjunctive and comeal infection and ulceration.

2. Nursing of the nose: Take care to keep respiration unobstructed. Frequent smearing of MEBO is necessary to avoid drying and bleeding.

3. Nursing of the ear: Don't press the ear. Prevent ear chondritis.

4. Nursing of the mouth: Avoid drying and contamination.

5. Nursing of the respiratory tract: Keep respiration unobstructed. When necessary, perform tracheotomy. After tracheotomy, attention should be paid to prevent air way obstruction by necrotic tissue in the tract. Timely clearing of the inner tube of the canula.

6. Nursing of the hand: Use MEBO gable to replace vaseline gauze for bandaging, to keep the hand in normal functioning position.

7. Nursing of the perineum: Keep the perineum clean and exposed. Protect the wounds using MEBO gauze and smear MEBO directly onto the wounds.

A Draft of the Nursing Routine for MEBT

(Abstract)

Zhao Yang

(HospitaI of Kaifeng Air conditioner Factory, Henan Province)

As MEBT and MEBO are more and more Widely accepted in ciinipal practice, a complete nursing technique which suits to the treatment is of urgent need. This draft is made on the basis if the theory of " Burn and Wound Medicine" of Prof. Xu Rongxiang add our clinical experience. This draft includes burn ward management system, nursing routine for wound management and infection prevention, nursing routine for shock prevention aam treatment and nursing routine for burns of the special parts of the body.

Progress in Clinical Research and Treatment of Deformity of Burn Patients at the Later Stage in China

(Abstract)

Hao Xinguang Liu Yongyi Luo Shaojun He Dongcheng Yan Dasheng Tang Skaoming Gu Daming

(Research Debt. of Plastic Surgery, Guangdong Medical Colleae)

This paper deals with the recent progress in clinical research on burn deformity in China. The authors review their own experience in the past years and the experience of other workers home and abroad. The authors make comments and suggestions on the classification of facial deformity, the choice of the methods for treating face, neck and hand deformities, indication and limitation of various skin grafting techniques for treating deformity of the above ststed parts of the body and evaluation of the results of surgical operations, etc. the authors desigh and describe different types of skin flaps, skin tubes and free skin flaps with extraordinary large area and the method of their use in the repair and the treatment of facial and neck deformities.