目录

Changes in the Functioning of Gastrointestinal Tract after Severe Burns and Wounds

(Abstract)

Zhang Xiangqing

(Dept.of Burn Surgery, No. 91 Hospital, Burn Center of Jinan Mmtary Region)

Gastrointestinal tracts have long been considered to be in a static and unactive state after severe burns and wounds. Therefore they are not so much concerned as compared with organs such as lung. heart and kidney. This false impression is due to lack of measures for monitoring the functioning of the gastrointestinal system. When severely inflicted. respiratory and circulatory systems give "tempestuous" responses which draw the attention of the doctor, while gastrointestinal system does not give such responses. In recent years, many research reports have revealed that after severe burns and wounds, changes in the functioning of the gastrointestinal tracts are no less than those in the lung, heart and kidney. In this paper. the author described, in three aspects. the changes in the gastrointestinal functioning in the acute responsive state after burns and wounds.

1. Stomach is one of the central responsive organs of burns and wounds. In the course of treating large area burns. the use of sophisticated instruments such as fiber--gastroscope, causes increases in the incidence of complications. Many research reports proved that the necrosis of the superficial mucous membrane of the stomach is the main injury after responsive reactions and may occur in 24 hours after won nded.

2. The destruction of the enteric mucous membrane barrier is the prerequisite for the migration of enteric bacteria. A vast amount of research proved that the early secondary infections after severe burns and wounds are from enteric cavity. The author suggested that the main causes of the migration of bacteria are : (1) the weakening of the defensive power of the host which results in- an increase in the susceptibility to infections, (2) the destruction of enteric fmucous membrane barrier which accelerates the migration of bacteria into the blood stream. and (3) the afteration of intestinal flora which increases the possibility of hematogenous dissemmation.

3. Gastrointestinal tract is the "hotbed" of infectious multiple system organ failure (MSOF). MSOF is a severe disease now considered as a new syndrom. The mechanism of the coming on of MSOF is rather complicated. In this paper, the author gave a discussion on two factors closely related to the functioninq of the gastrointestinal tract. One is the decrease of blood flow in the intestinal tract and reperfusion injury. and the other is enteric endotoxin and organ failure.

To sum up. the author concluded that changes in the functioning of gastrointestinal system after severe burns and wounds are very signify leant. They may play a "trigger" role in the incidence of many complications. Therefore we should reconsider our views and measures should be taken to protect the functioning of the gastroint6stinalnsystem during the con rse of treating severe burns and wounds.

Moist Burn Ointment for Treating Stubborn Residual

Wounds after Severe Burns

(Abstract)

Liang Darong

(Dept. of Burn Plastic surgery, Red Cioss Association Hospital, GuangZhou)

Conventionaj dry therapy accelerates the necrosis of stasis zone tissue and residual appendages of the skin. The wounds can not be repaired in a natural way and do not heal for many months. As a result. the immune function of the patient is damaged and stubborn residual wounds are formed. The patients become very weak and the bacteria on the wounds become resistant to many antibiotics. In such cases septicemia would occur. It is a difficult problem to tackle in clinic. The author used moist exposed therapy and Moist Burn Ointment for treating such cases. High efficacy and short treating course have been achieved.

Caacal Expeience in Treating 30 Cases of Burn with Moist Therapy

(Abstract)

Tao Zhili, at al.

(Dept. of Burns, People's Hospital, Shaanxi Province)

In their 3 month clinical practice. the authors treated 30 cases of burn of various causes with moist therapy. All the patients were healed. The authors concluded that the new therapy has marked analgesic effect. It protects the wound surface and stops the progressive sloughing of the stasis zone tissue, keeps the drainage effective and markedly reduces the infective rate, For deep second degree burns no scar will be left. It has a short therapeutic course. The number of patient to be submitted to operation can be reduced by using this therapy. A discussion on Subjects concerned is presented.

Experience in Treating a Case of Deep, Large Area Burn after Excision of Necrotic Tissue

(Aboact)

Qian Yuulian, et al.

(Medical Center of Burns Wounds and Scarce Ulcers, China National Academy of Traditional Medicine)

A case. of deep, large area burn (burnt area 30% deep second degree 10% and third degree 20%) was treated with moist exposed therapy. Moist Burn Ointment was applied after the patient was hospitalized. After the shock stage, the necrotic tissue was excised and the application of the Ointment was continued. The patient healed in good functioning and good appearance, without leaving any scar.

The result proved that coordinated treatment of excision of necrotic tissue and moist exposed therapy helped to revitalize the stasis zone tissue, to preserve the residual skin appendages and to promote the proliferation of the cell into skin islands which gradually grew to join the epithelia on the won nd edge to cover the granulation of the won nd. Skin grafting was avoided.

Clinical Observations on 23 Cases of Burn Treated with Moist Exposed Therapy

(Abstract)

Li Xiuzki

(Dept. of BUrns, People's Hospitai, Guangdong Province)

The author treated 23 burn patients with moist exposed therapy and concluded that the unique advantage of the therapy is to keep the wound surface moist but not macerated, so that the deepening of the necrosis due to dehydration of the wound surface could be avoided. The therapy solved many difficult problems in the treatment of burns, such as pains. infections, scars Ie fi for deep second degree burns and necrosis of the stasis zone tissue, etc. It is an idea and convenient method for treating burns.

159 Cases of Burn Treated with Moist Burn Ointment

(Abstract)

Wang Shuyan

(Hospital of Communications, Shangdong Province)

The author concluded through the experience on treating 159 cases of burn with Moist Burn Ointment that the drug has refiable analgesic and antiinfective effects and is capable of revitalizing the stasis zone tissue and promoting the growth of the epithelia. When timely treated. deep second degree burns would heal without leaving any scar. It is very efficacious and convenient for use. The therapeutic course is short.

Emcacy Analysis of 31 cases of Electric Burns Treated with Moist Exposed Therapy

(Abstract)

Sun Yaping, et al.

(Dept. of Burns, Electricity Hospital. XuZhou)

As the living standards of the people are rising, the use of electric appliance has been popularized. The number of patient with electric burns has been increasing in recent years. Electric burn is a burn of special cause. It is always more serious than burns of other causes. To recover the function of the burnt tissue is a hard task in clinic. Conventional therapy for second degree electric burns includes desication of the wound, excision of the scab and covering the wound with flap. The patients have to endure pains and psychological burdens. The operation often results in disablement. During the excision of necrotic tissue, a part of normal tissue is inevitably excised at the same time. The recovery of the function is often unsatisfactory.

The authors used moist exposed therapy for treating 31 cases of electric burns and recognized that this therapy keeps the wound surface in a moist environment and protects the tissue from dying. The tissue which is in a parabiotic state can be reversed to normal. The therapy alleviates the injury of the wound surface and accelerates its repair. It has a unique efficacy for treating burns of the functional parts of the body.

2 Cases of Pitch Burn on Face and Neck Healed by Moist Burn Ointment

Healed by Moist Burn Ointment

(Abstract)

Zeng Jiniian, et al.

(Dept. of Burn Plastic Surgery, No.98 Hospital of PLA)

This paper reports 2 cases of pitch burn on face and neck healed by treating with Moist Burn Ointment. The skin on the face remained intact. No scar left and no change in pigmentation found. The wound surface contaminated by pitch was made clean in 8 hours after smearing of the ointment. No infection, no bleeding and no pain had been recorded. The wound was getting healed without being further damaged as the ointment was applied continuously. The treatment was simple and convenient.

Clinical Experience in Treating 57 Cases of Yellow Phosphorus Burn

(Abstract)

Liu ChangZhen, et al.

(Zibo Hospital, China Burns and Surface Ulcets Science and Technology Center)

57 cases of yellow phosphorus burn were treated at early stage with 3% silver nitrate and sodium bicarbonate of the same concentration. The burnt area amounted at the most to 51% of body surface. All the patients were healed. The key to the treatment is to take timely measures to quench the phosphorus fire. to remove the toxic effect of phosphorus and to prevent absorption of phosphorus. Silver nitrate is reliable and safe for use to quench the phosphorus fire and to remove the toxic effect of phosphorus. The mechanism of its action can be explained by the following chemical reaction:2P+7H2O+8AgNO3-8Ag +8HNO3+H3PO4+H3PO3

Sodium carbonate is used to neutralize the acids.

Copper sulfate which had been used for treating phosphorus burns is easy to be absorbed. Silver nitrate is therefore, superior to copper sulfate for this purpose.

Moist burn ointment has instant analgesic and antiinfective effects. It promotes local blood circulatibn. accelerates the liquefication of necrotic tissue, the proliferation of residual skin appendages and promotes the r6pair of the wound. For deep second degree burns no scar will be left after healing.

Application of Moist Exposed Therapy in Treating Large Area skin Laceration

(Abstract)

Wang Peiskeng, et al.

(China Burns and Surface Ulcers Nanyang Science and Technology Center)

This paper reports in details the case history of large area skin laceration and infections of the wound surface of multiple fracture of ribs. treated with moist exposed therapy. The method of treatment is similar to that of treating burns. Good analgesic and antiinfective effects, improvement of local micro--circulation and immune function, promotion of epithelial proliferation and effective drainage had been achieved. The therapy had high efficacy, short therapeutic course and left very few scars.

86 Cases of Cervical Erosion Treated with Moist Burn Ointment

(Abstract)

Zkong Chongxin, et al.

(People's Hospital, Zhangqiu County, Shangdong Province)

Cervical erosion is a common gynecopathy. Conventional therapy requires a long therapeutic course and has low efficacy. It is painful to the patients. The author used Moist Burn Ointment for treating this disease. This drug is non--toxic and has no side effect. It promotes proliferation of the cell in cervical mucous membrane. enhances local immune funotion and protects the wound surface from contact with acid excretion of the vagina and thus eliminates the basic cause of erosion. This drug is very convenient to use and is acceptable to the patients. It has high effecacy and short therapeutic course. Moist Burn Ointment is an ideal drug for gynaecological use.

A Case of Eczma and Contact Dermatitis in Both Hands Cured by Using Moist ' Burn Ointthent

(Abstract)

Pn Zuyu

(Dept. of Surgery, People's Hospital, Xinduan County, Hunan Province)

"Burn is a combination of wounds and ulcers of all kinds." This is the theory which is the foundation of the medicine of burns and surface ulcers. On this basis, the author used Moist Burn Ointment for treating eczma and contact dermatitis for many years and got satisfactory resuits. The author recognized through his clinical practice that improvement of local micro-circulation as well as analgesic, anjipruritic and antiinfective effects can be achieved when moist exposed therapy and Moist Burn Ointment is used for treating dermatosLs, just as it is used for treating burns. It helps to enhance local immune function and to regulate nerves. Stubborn dermatosis can be cured and the short term results are very satisfactory. The long term results remain to be fu riber observed.

A Case of Gangrenous Dermatitis Caused by Fulminant Epidemic Encephatihs Healed by Treating with Moist Burn Ointment

(Abstract)

Li BaoZbong, et al.

(Dept. of Burns, Changchun Central Hospital, Jinn Province)

This paper reports a case of gangrenous dermatitis caused by fulminant epidemic encephatitis healed by treating with Moist Burn Ointment. The author concludes that Moist Burn Ointment has good efficacy for healing all kinds of wounds, surfacpe ulcers and gangrenous fool. The method of treatment is similar to that of treating burns. The author Suggests that the ointment be widely. used in the clinic of dermatosis. This is a new approch to the curing of diseases.

Moist Burn Ointment for Treating A Case of Tissue Necrosis Caused by Rivanol Necrosis Caused by Rivanol

(Abstract)

Nie Yun

(The 1st Surgery Dept., People's Hospital of Yunyang County, Sichuan Province)

This paper describes in details a case of deep tissue necrosis caused by rivanol. The author concludes that Moist Burn Ointment is highly effective for treating deep tissue necrosis caused by drugs. The key to good healing is to keep the wound and the necrotic tissue exposed, so that the drug can make full play to its effect.

A case of Canceration of Scar on Burned Scalp

(Abstract)

Li Wendong, et al.

(China Burns and Surface Ulcers Science and Technology Center)

This paper reports a case of canceration of atrophic scar on burned scalp after 16 years of burn. Frequent scratching of the scalp whore the scar itched and repeated diabrosis of the scar made the ulcerS long unhealed. On this basis. the ulcers spread into a cauliflower like shape and formed a protuberance on the scalp, where the blood bleeding was difficult and the excretion was increased and was ill--smelling. These were the typical symptdms and the physical signs of canceration. The author used moist exposed therapy in treating the case and resulted in marked improvement of the symptoms and physical signs.

With a vast amount of data, the authors described the course of canceration and his own experience in treating the case. For prevention of the canceration of scar, timely application of the moist exposed therapy is advised. This therapy helps the wound to heal in a natural way without disturbing its biological order and helps to reduce the formation of the scar. The unstable scar and radiation ulcer formed after conventional therapy should be excised as early as possible. Early diagnosis is of great importance. Patients with repeated diabrosis of the scar and persistent ulcers should be considered to have the possibility of canceration of the scar. Patients with scar cancer are usually submitted to operation.

The Application of skin Flap and Musculocutaneous Flap in the Repair of Deep Electric Burns at Early Stage

(Abstract)

Huang Xiaoyuan, et al.

(Dept. of Burn plastic surgery, The lst Ameated Hospital of Hunan Medical Uaiversity)

7 cases of severe electric burns in jaw, neck and four limbs had been repaired using axial flap. musculocutaneous flap and free skin flap with satisfactory results. Amputation and hemorrhage had been avoided. A discussion on the treatment of the wound. selection of the flap and points for attention during the operation and post--operation period is presented and literature cited.

The Application of Island skin Flap in the Repair of Knee and Heel Tissue Defect

(Abstract)

Fan Wenfu, et al.

(Dept. of Orthopaedics, People's Hospital, Xiuye County, Henan Proriuce)

Knee and heel are important parts of human body. Tissue defect in these regions should be repaired by a proper method to ensure complete re covery of the function. In our hospital. island skin flap had been used to repair 1 2 cases of knee and heel tissue defect, since 1985. The defect area ranged from 4 x 3cm2 to 29 x 17cm2. 5 kinds of pedicle flaps had been used. All the wounds had been healed by first intention.

If tissue defects were not timely treated in a correct way. Chronic ulcers would appear. Fibrosis and adhesion of the subcutaneous tissue and the skin around the wounds would occur. Local blood supply was reduced. The skin became brittle and the resistance against infections was lowered. The ulcers would expand and new ulcers would be formed. When a combination of osteomyetitis and ulcers happened, a vicious circle was formed. The healing of the ulcers and osteomyelitis became more and more difficult. Conventional therapy takes a long time to cure the disease. It is painful to the patient and the results are always unsatisfactory. The application of pedicle tissue flap can overcome these shortcomings and give good results. In the application of this method, factors such as location, property, size and pressure of the defect tissue should be taken into consideration one by one. If possible, local skin flap repair is recommended because it is easy to operate and gives good results.

To repair knee wounds, many kinds of flaps can be used. Flap from medial part of the shank is easy to cut off, but the operation will damage a main artery. Flap from lateral part of the shank is difficult to cut off, though the operation does not damage any artery, its application is limited. Saphenous artery is a good donor region. It is considered the best alternative. It has a large area and is easy to cut off. The operation does not damage any artery and the region is covered up.

Heel is a part which takes most of the load of the body. It is always under pressure and has a greater friction. To repair heel tissue defect requires not onfy a sufficient stuffing of the subcutaneous tissue but also a good sensation, a dense wear-resisting tissue and a reliable blood supply. Medial plantar flap has a dense tissue .which is wear-resisting, rich in elasticity and good in sensation and has a solid shape. It well meets the requirements of the special function of the heel. Medial plantar flap is therefore. consid ered best to be used for repairing heel defect.

The Appncation of Island skin slap from Dorsal Part of index Finger

in the Repair of Thumb Defect , pair of Thumb Defect

(Abstract)

Yu Mingxing, et al.

(Dept.of Burns, Xiaugfan Hospital of PLA Air Forces)

10 Cases of thumb defect had been repaired using island skin flap from dorsal part of index finger with satisfactory results. The author described in details the design of the island skin flap, the method of operation and the points for attention during the operation and post--operation .period. A discussion on the repair of thumb defect and the recovery of its functioning is presented and a vast amount of literature cited.

A Comparative Study of the Effects of Moist Burn Ointment,

Silver Sulfadiazine and Hot Dry Exposed Therapy on Controlling

Pseudomonas Aeruginosa infection of Burn Wounds

(Abstract)

Chen Xiaowu, et al.

(The 18t Acetated Hospital, Hunan Medical University)

This paper reports a comparative study of the effects of moist burn ointment, silver sulfadiazine and hot dry exposed therapy on controlling pseudomonas aeruginosa infection of burn wounds.

120 white rats. purebred, were scalded on the back to form third degree scalds and then infected with 4 x 108 pseudomonas aeruginosa. The anti inals were divided into 4 groups. 30 in each. Animals of different groups were kept in separate cages. The control group received no treatment. while the 3 test groups were treated with hot dry expoSed therapy. moist burn ointment and 1% silver sulfadiazine respectively. 1,3,5,7 or 9 days after treatment, the animals were killed. Biopsy specimen and heart blood samples were collected for determination of bacteria count of the tissue under scab. examination of pathological section and heart blood incubation. The results revealed that animals in the moist burn ointment group and silver sulfadiazine group had fewer bacteria counts and lower positive rates of blood incubation and pathological examination than those of the control group. The differences were significant. But there were no significant differences of the above mentioned data betweem the hot dry exposed therapy group and the control. This led to the conclusion that moist burn ointment and silver sulfadiazine had the efficacy of controlling pseudomonas aeruginosa infection of burn wounds, while hot dry exposed therapy had not. The results also revealed that there was a positive correlation between bacteria count of the tissue under scab and the positive rate of pathological examination. Both methods gave same diagnosis of infection of burn wounds. There was no significant difference between the diagnosis rates of the two methods. The authors concluded that under scab tissue bacteria count is still of value for the diagnosis of burn wound infections.

Correlation Analysis between Plasma Proteins and Colloid Osmotic Pressure in Burns and Traumatic Patients

(Abstract)

Wang Yong--Wu, et.al

(Burn Department and institute, 91st Hospital, PLA)

Determination results of plasma proteins and its COP with correlation analysis between them in 122 burns and traumatic patients was reported. There were highly positive correlations between total serum proteints, albumin, their general coefficients and COP. Their linear regression eguations had been obtained as follow :

Y(COP, mmHg) = 2.45x(total serum proteins. g/dI)+5.81

Y(COP. mmHg) = 3.44x(serum albumin, g/dI)+8.45

Y(COP, mmHg) = 0.67x(general coefficients) +7.1 9

General coefficients: 1g / dl globulin 1, 1 g / dl albumin, 5. The three regressions eguations confidences are more than 95 percent.

Key--wordsf Burn, Trauma, Serum Protein, COP.

Experimental Morphological Study on Microcirculatory Vascular Tree of Skin(II)

(Abstract)

Bat Shaling,et al.

(Department of Anatomy, China Medical University.)

Using the method of cutaneous vascular cast and scanning electron microscopy. We studied the special morphological characteristic of the microcirculatory vascular tree of skin in the nail bed, prepuce, toe prints and glands of penis. The special regulation of three dimensional architecture of microcirculatory vascular tree of these special skin area were revealed, at first time, in detail at home and abroad. This study enriched the theoretical content of the microcirculatory vascular tree, and provided the vascular experimental morphological evidences for the cutaneous microcirculatory function of these special skin area and for the vascular architectural characteristics of the skin striae.

Clinical Analysis of 131 Cases of Postburn Diarrhea

(Abstract)

Zhang Hong

(Dept.of Burns, No.159 Hospital, PLA)

There is a small number of papers dealing with postburn diarrhea so far. We had treated 131 cases of postburn diarrhea (1.21% of the total 10823 cases) in the past 31 years (1958--1989). The etiology analysis showed there were 8 cases (6.1%) with dysentery. 7 cases (5.34%) with infectious diarrhea. 35 cases (26.72%)with alteration of intestinal florea, 27 cases (20.61%) with enteritis due to bacterial infections difficult to identify and 54 cases (41.22%) with their clinical manifestations similar to those of alteration of intestinal florea or enteritis due to bacterial infections difficult to identify. but the laboratory exam. mations had not been done completely. In this paper, the essential points for diagnosis and prevention and treatment of postburn diarrhea are described.