目录

The Early Treatment of Moderate and Severe Burns and its Theory Basis

(Abstract)

Fu Qinglin,Geng Mingzhen

(Hospital of Tralditional Chinese Medicine,Hua county, Henan Province)

The article described the following matters concerning the early treatment of moderate and severe burns.

1. The transfusion composition in the treatment of early shock, electrolyte changes and the treatmenl of inhalation air passage injury.

2. The metabolism and nutrition of burn patients, expecially the advantages of taking food early and advantages and disadvantages of the taking of some nutrition.

3. The comparision between SD--Ag, SD--Zn and MEBO in the treatment of burn wounds. The results showed that MEBO had better effects.

4. The introduction of the harm of vesicle fluid. The majority of scholars advocate withdrawing blister fluid and preserving blister skin as a nutural dressing.

5. Satisfactory analgesic effect of MEBO.

6. Burn infection prevention.

An Analysis of the Causes of 247 Cases of Burnt Children in Yantong Area

(Abstract)

Zhang Qiang

(Dept. of Burns, No. 322 Hospital of PLA)

From January 1987 to December 1989, the author treated 247 burnt children, which accounted for 43.l% of the total treated patients. On the basis of case analysis, he thought that the main cause of burns in children was the heatable brick bed. The important cause was the unproper management of heat sources. The number of children older than 5 years burned by flame was more than that burned by hot liquid. The author also offered a few suggestions of burn prevention.

The Exploration of Pathological Changes and their Mechanism of Experimentally Burned Rabbits after Treatment

(Abstract)

Wang Guangshun, et al. (Dept. of Burns, Affiliated Hospital of Taishan Medical College)

The Writers prepared animal models of deep II burns of rabbits. Then the burnt animals were contaminated by staphylococcus aureus and divided into two groups. Animals in control group were treated with vaseline and animals in experimental group were treated with MEBO. All the animala received exposure therapy. Dressing change was conducted regularly. The wound tissue was sampled between 3--22 days of burning. After staining, the samples were examined under optical microscope.

The results showed that in control group, the wounds repaired slowly. Neoformative blood capillaries were rare with a small luman. The tissue was swollen with fiber proliferation. Inflammatory cells invaded widely. Collagen fiber broke. Epiderma didn't regenerated and covered wounds. Finally, hypertrophic scars formed. While in experimental group, burn wounds repaired rapidly. Epiderma regenerated activefy through risidual skin appendages. There were a lot of blood capillaries with big lumen. Macrophage ic granulation tissue increased. Finally the wounds were covered by squamous epithelium. No scars formed. The experimental results were in accordance with clinical observation.

This experiment indicated that MEBO made tissue proliferate in a relatively physiological environment which conformed to the regenerating law of tissue. As a result, scar formation could reduce to the maximum limit.

The investigation and Analysis of Common Bacteria of infected Wounds and Drug Sensitivity Test in the Last Six Years

(Abstract )

Zhu Xiaoqin, Chen Guoqing

(Dept. of Burns and Plastic Surgery, Ma Anshan People's Hospital)

The authors cultured common bacteria of burn wounds for six years from 1985--1990 and made a Survey of the sensitivity of sixteen kinds of antibiotic. Among the infectious bacteria, gram positive bacteria accounted for 61. 61%, gram negative bacteria accounted for 36. 84%, P<0.01. There was a significant difference between them 10 kinds of common pathogen accounted for 74.81% of total detected strain. Staphylococcus aureus was 23.36% of total, ranking the first. Pesudomonas Aeruginosa was 18.99% of total, ranking the second. Both of them were the commonest pathogen. The sensitivities of 10 common pathogenes to 16 common used antibiotics showed that the sensitivity of antibiotic to gram positive pathogen was higher than that to gram negative pathogen.

Amikacin and neomycin are broad--spectrum antibiotic. Their sensitivities to G+ bacillus and G- coccus were relatively higher, The sensitivity rate of polymyxin B. amikacin and neomycin to Gbacillus was 91.67%, 82.41% and 66.7% respectively. The sensitivity rate of amikacin to pesudomonas aeruginosa was 78.79%. So amikasin was chosen first for anti pesudomonas aeruginosa infections. The sensitivity rate of furantoin, neomycin and amikacin to G+ coccus was 83.33%, 81.75% and 77.28% respectively. The sensitivity rate of amikacin and neomycin to staphylococus aureus 83.33% and 75.00% respectively.Amikacin was chosen first to anti staphylococcus aureus infections.

The Dynamic Observation and Clinical Evaluation of Serum Complement of Burn Patients (32 case analysis attached)

(Abstract)

Chen Cunfu、Zhang Xiangqing、Zhao Cunrong、Han Yuqing

(No. 91 Hospital of PLA)

The writers detected the CH50，C3and C4 of 23 burnt patients and 35 normal adults as control at the same time. Blood sample was taken on the 3th. 7th. 21th and 28th day of burning respectively. Results analysis showed that the level of above 3 kinds of complement of patients were all lower than that of normal and then it went up gradually. At the third week of burning, the complement level was about to become normal. At the fourth week of burning, it was a little bit higher than normal. Comparing with control group, the P value was <0.05.

THe complement content of patients whose BSA burn was smaller than 30% changed slightly. The comparision of complement content between patients with BSA burnt over 30% and normal people showed that there was a significant difference between them (P<0.01 ). The complement level of extensive burn patients, especially the patients with BSA burnt over 80%, decreased rapidly at early stage of burning. The complement level of dying patients went down greatly. Sudden drop or over low of complement level is a inansipicious sign and should be paid much attention to.

The Significance of Monitoring Per--hour Output, Specific Gravity and PH Value of Urine in Emergency Treatment of Extensive Burn Shock

(Abstract)

Ye Zhenwu

(Dept. of Burns, Dandong Railway Hospital)

The author introduced the important effects of monitoring per hour output, specific gravity and PH - value of urine on directing grass--rooted hospitals to infuse the patients suffered from extensive burn shock with fluid.

The author also described briefly the mechanism, method of operation and clinical significance of monitoring urine in the treatment of extensive burn shock and offered a simple and practicable monitoring standard for fluid replacement in the treatment of extensive burn shock at grass--rooted hospitals. The writer introduced a typical case at the end of the article.

The Change of ALT OF Burn Patients

(Abstract)

Zhangkai et al.

(Medical center for Burns,Wounds and Ulcers. Binzhou Medical College)

The authors summarized the change of Alanine Transaminase (ALT ) of 230 burn patients hospitalized from 1988--1991 and found out that ALT rising related not only to burn injury itself but also to some drugs and virus hepatitis. Among 230 cases, there were 30 cases with ALT rising, accounting for 13% of the total cases,ot which 6 cases were dead. The authors were convinced that ALT rising related to the intensity of burns. The healing of serious burnt patient with ALT rising was relatively bad. Post--transfusion hepatitis could cause ALT= rising. So it should be strictly controlled. Some drugs could also cause ALT rising.

The writers introduced the ALT rising of 3 out of 6 cases who had taken rifampicin. Some chemical burns could cause ALT rising as well.

When the ALT observation is taken, the liver function standards and clinical symptoms of burn patients should be concerned so as to analyse the cause of ALT rising and treat patient expectantly and etiologically.

Clinical Report of 336 Cases of Burns Treated with MEBO

(Abstract)

Jin Xiang Wei,et al.

(Burn Medical Centre,the Znd Hospital of Shaoxing Zhejiang Province.)

The authors treated 336 cases of burnt patients using MEBO from Ist. September, 1989 to 30th February, 1991. Among them, 228 cases were male, 108 cases were female. Their ages ranged from 5 months to 81 years old. The causes of burns included hot liquid, flame, chemical substances and electric shock etc. Intensity of burns, minor burns 174, moderate burns 118, severe burns 38 cases, exceptional severe 6 cases. Burn areas were 3%98%. 333 cases were cured and one case was dead. 2 cases left hospital voluntarily during the treatment.

The authors treated adult patients with MEBO and left the wounds exposed and treated burn wounds of trunk and extremities of child patients with MEBO treated dressing except for face and perineum area.

For deep burns,MEBO was used in combination with excision of necrotic tissue 2--3 days after burning. Doctors experienced that MEBT is an advanced scientific therapy invented by prof. Xu Rongxiang. The advantages of using MEBT and MEBO are: (1 ) The satisfsctory analgesic effect. (2 ) The powerful' anti--infection effect. (3 ) The effect of promoting epithelial tissue growth of deep burns without skin grafting. (4 ) The post--burn scar formation and pigmentation were obviously less than that of conventional dry exposed burn therapy. (5)the total volumes of fluid infusion and the doses of antibiotics were less than that of conventioanl exposed burn therapy.

The Experience of Treating III burns with MEBO

(Abstract)

Li Fengcltun,Yang Changping

(No.322 Hospital of PLA)

The writers Cured superficial III burns only by using MEBO without eschar excision. Deep III minor burns could be healed also through MEBO application,but it would take a longer time for them to be healed. Even though there was post--healing scars, the scars were less than those of burn woundS treated with dry exposed burn therapy (DEBT). In the treatment of deep III burns with relatively big BSA, they combined MEBO with eschar excision to enhance the eschar's sloughing as soon aspbssible. When the fresh granulation tissue formed, skin grafting was performed. The survival rate of skin graft was high. The writers made a comparision between MEBT and DEBT in the article. There was a significant difference between healing days of burns treated with MEBT and that of burns treated with DEBT.

Clinical Understanding of the Perineal Burn Treated with Moist Exposed Burn Ointment

(Abstract)

Zou Jiliang,Gong Baohai,Guo Baozeng

(Department of Burns and Plastic Surgery in the General Hospital of Huabei Oil Administration Bureau)

The authors treated 17 perineal burn patients with MEBO successfully. During the treatment, MEBO showed remarkable effect in anti--infection and the patients felt less pains. Being an ideal therapy to treat perineal burns,MEBT proves to be beneficial to the recovery of the tissue of the stasis zone and the healing of the body surface ulcers.

The Experience of Treating Perineum Burns of Children with MEBO

(Abstract)

Feng Jiqian

(Burns Department,Binjiang Hospital,Hengyang,Hunan Province)

The writer treated 15 children suffered from perineum burns by using MEBT and MEBO from 1988 to 1991,and received satisfactory results. Dr. Feng considered that MEBO had a reliable analgesic and strong anti--infection effect and little toxicity and side--effect. The therapeutic effect of MEBO was fine. The course of disease of burns treated with MEBT/MEBO was shorter and there was no scars in deep R o burns. So MEBO is suitable to child patients. In the treatment of child perineum burns, MEBT/MEBO have great advantages as beyond with other treatments for child perineum burns.

Treating Burns due to Hydrogen Balloon inflammation and Explosion

(Abstract)

Fang Doughal,Zhu San,Guo Yuanfa

(Kun Ming General Hospital,Cheng Du Military Region of PLA)

The writers treated & cases of burns due to hydrogen balloon inflammation and explosion in 1990 with MEBO and gained good effects. The BSA burn of patients was 4. 5% to 8%. The degree of burns was superficial II. The burnt positions were face, neck, forearm and dorsum of hand. Some cases suffered from conCurrent injuries of broken glass. The lacerated wounds were sutured and burn wounds were treated with MEBO and MEBT. The average days of hospitalization were 8 days.

A Case Report of Radioactive Ray Burns

(Abstract)

Zhao Yongan

(Worker's Hospital,Hubei Province Steel Wire Factory)

The writer introduced one case of carcinoma of penis. After the focal excision of penis, the wound healed well. 3 months later, the patients received radiotherapy. On the second day of the third period of treatment, the penis was swollen and painful. There was a most pronouaced itch in penis. The penis was scratched by the patient and he was transferred to the writer's hospital. The scratched ulcer was smeared by MEBO. A few minutes later, ulcer pains disappeared. Gradually, the ulcer oedema abated and exudate of wound reduced. On the gth day of hospitalization, the patient was cured and discharged from hospital.

Experiences of Nursing 100 Serious Burn Patients Treated with MEBO

(Abstract)

Li Zhenghui

(No.364 Hospital,Ministry of Aeronautic and Space industry)

The writer introduced the experiences of nursing 100 serious burn patients who were treated with MEBO in Dr Li's hospital. The largest BSA burnt was 95%, and the smallest was 57%. Only two cases were dead.

In the article,the writer described in the areas of shock stage nursing and the management and nursing of wound, nurtrition and function exercise and phychonursing.

Experience of Nursing 44 Extensive Burn Patients Treated with MEBO

(Abstract)

Shen Hongmei

(Burn Medical Centre,the Second Hospital of Shaoxing,Zhejiang Province)

The hospital treated 44 extensive burn patients by using MEBO from Jan. 1989 to Feb. 1991 and gained good results. During the nursing of 44 extensive burn cases, the writer got the following experiences:

1. It is an important measure to establish the passage of venous transfusion as soon as the patient is hospitalized in order to treat extensive burn shock. Meanwhile take the following treatment measures:debriding wound simply,reducing wound pains by MEBO application, keeping room temperature and observing urine output and respiration.

2. Wound nursing: follow the aseptic manipulation strictly and clear liquefactive substances timely. In order to Dromote the wound healing of deep II and superficial III burns, the eschar excision is performed at the early stage of Iiquefaction in combination with MEBO.

3. Nutrition nursing: in addition to intravenous fluid replacement,patients should be encouraged to take fluid.

4. Psychotherapy: help patients establish confidence in their recovery and Let them cooperate well during the treatment and nursing.

The Experience of Treating Deep Degree Burns of Face by Combinative Therapy of MEBT and Moist Semiexposure Burn Therapy

(Abstract)

Yu Xien

(Hospital of Naming Chemical industry Company)

The author treated 133 cases of burns of head w and face by Moist Burn Medical Technique and MEBO from June 1989 to Dec.1991.

Among the patients, 56 cases were deep E o burns of face and treated by combinative therapy of MEBT and Moist Semiexposure Burn Therapy (MSEBT). As a result,the period of treatment was cut short and the incidence rate of folliculitis of wound surface and its margin was cut down. The therapeutic effect was satisfactory. At the early stage,the author applied MEBTand MEBO. As the Iiquefactive substance was discharged, MEBT was applied. According to the size of wound, a single layer of gauze was cut to a corresponding size and treated by MEBO. Then it was covered on the wound surface, The dressing was changed every day. As the wound surface was getting smaller,the size of gauze was cut down relevantly until the wound healed completely.

Comparing the simple MEBT and the above mentioned combinative therapy, the author thinks that the later can enhance the wound heal early and reduce the incidence rate of folliculitis. There is a remarkable difference between them.

Employing MEBO Treats Bedsore

(Abstract)

Zhang Shuchao, Song Jiezhang et al.

(Paraplegia Sanatorium of Tangshan)

This paper reports the experiences of curing 32 cases of bedsore by MEBO. Through the clinical observation the authors found that the bedsore of third degree with minor size could heal within 1015 days, that of fourth degree with moderate size became recovered within 20--30 days. The average healing time was 15. 4 days. MEBO application can prevent burn wound infection, improve microcirculation of wound surface and tissue around it and promote metabolism of local tissue so that the wound of bedsore heals. The method of adopting MEBO for bedsore is handy and efficient. It is worth using and popularizing.

A Case Report of Allergic and Supurative Dermatitis Treated with MEBO

(Abstract)

Lu Kaizhao

(Hospital of Zaozhuang Mining industry Bureau, Shandong Province)

The author treated a patient suffered from extensive pustule of lower limbs in August, 1991.

At the first, the patient had a pain in the lower limbs. After the safflower oil was used, the eruptions appeared. Then they developed into extensive pustule. The patient had had a fever for ten days before he was hospitalized. The somatoscopy and laboratory examination showed that both sides of the two legs were covered by suppurative ozzing. The wounds were like the infected deep II burns. There were patchy and scattering red papular eruptions on the upper limbs, middle abdomen and perineum. The body temperature was 39C. White blood cells and neutrophilic granulocytes were rising. Staphylococcus aureus was cultured from wound exudate. After the patient's hospitalization, MEBO was smeared on the wounds. Antibiotics and dexamethasone was dripped intraveously. 5 days later, the clinical symptom was totally controlled and systemic treatment was stopped. On the 12 days of admission, the patient was pured and discharged from hospital.

A Report of Treating 56 Cases of Cold injuries with MEBO

(Abstract)

Wan Changxing

(Hospital of Chinese Traditional Medicine,Jinghai County, Tianjing)

The writer treated 56 patients of cold intones with MEBO from 1989--1990, and gained good effects. (For I--II cold injuries without exudate, MEBO was smeared directly on the wound. Then the wound was covered by gauze, encapsulated by plastic film and. bound up by bandage. ) For II--III cold injuries with blisters, the wound was sterilized by 75% ethyl alcohol and the vesicle fluid was withdrawn by syringe or discharged through a small hole cut by scissors. Ulcerated wound could be cleaned up by normal saline or hydrogen dioxide solution. The necrotic tissue of wound could be cut away. Later on, the wound was dried with gauze, and smeared by MEBO, covered by gauze and bound up by bandage. The dressing was changed once a day. The cold injuries were healed within 4 days to 18 days. In general, it took 7-- 10 days for the wound to be recovered. No scar and pigment left.

The Comparision between MEBT and DEBT in the Treatment of Decubitus and Nursing Experience

(Abstract)

Dengjuan

(Surgery Department, Hospital of Oil Chemical Industry Factory, Wu Lumuqi)

The writer introduced the treatment of sacral decubitus of two traumatic paraplegia patients by using MEBT and DEBT (Dry Expourse Burn Treatment) respectively. One bedsore of bigger area was treated by MEBT. Another bedsore of smaller area was treated by DEBT. It took 38 days and 90 days for the bigger bedsore and smaller bedsore to be healed. The healing time of the latter was 2.4 times of that of the former. The healing speed ratio of the former to the latter was 6.6: 1. The post--healing scars of the former was even and a little bit hard. While that of the latter was uneven and hard. The healed skin of the former was smooth and with a light colour. That of the latter was rough with a dark purple colour. The writer was convinced that using MEBO was simple and handy. It's easy for the nurse and the patient to accept. The nursing principles are to turn over, clean, massage and look over the patients freouentlv.

The Application: of Transplantation of Greater Omentuni with Vessel Pedicle PIns intermediate Split Thickness Skin Grafting in Burn Surgery

(Abstract)

Fang Doughal, Li Zhuyi, Li Qixun, Guo Yuanfa, Zhucan, Zhou Tianhua

Since 1979, the writers repaired 7 burn injuries of different stages by means of transplantation of greater omentum with vessel pedicle plus intermediate split thickness skin grafting and got satisfactory results.

The article discussed the characteristics of greater omentum, indication of the operation and the successful conditions for the operation.

Transplantation of integreted Small Dermal Graft--An improvement in the Transplantation of Small Free Dermal Graft

(Abstract)

Qi Shunzhen et al.

(Burn Department, Beithune international Peace Hospital of PLA. )

This is a report on the 374 cases of transplantation of integreted small skin graft--an improvement in the transplantation of small and free skin graft--practised in the writer's hospital from Jan. 1988 to Dec. 1991. The grafting area ranged between 95cm2 and 5250cm2. There were 169 cases treated with transplantation of small and free 'skin graft from Aug. 1985 to Dec. 1987. The writer took them as a control group in which the grafting area ranged between 75cm2 and 2350cm2.

Two binary linear regression equations were established in accordance with each transplantation. The one of the conventional transplantation was Y1= 56.92-8.53x1+ 15.98x2, and the one of improved transplantation was Y2= 25. 07-1.17x1+6.89x2. It was proved through F test that the improved technique could markedly save the operation time by 47.0-52.9%.

Method:

Dry the disinfectant gauze which has been soaked in aseptic saline and fold it in 6--8 layers. Cut the autografts of patient into the size required and put them on the grafting areas. Put the gauze with small skin grafts on the accepting areas directly and press it mildly. Then remove the gauze slowly. Transplantation of small dermal graft is time--saving and no special condition and facility are needed. And above all, the survival rate of grafts is high. Therefore, doctors conclude that it's a simple and practical technique in skin grafting.

To Repair the Soft Tissue Defect of Extremities with Island Flap

(Abstract)

Song Jixue, et al.

(Microsurgery Department of Siping Central Hospital, Jiliu Province)

From Oct. 1985 to May 1991, the writer used six kinds of island flap with vessel pedicle of extremities to repair 27 various defects of soft tissue. The repairing of total cases was successful except one failure case. The advantages of the operation are: the blood circulation of flap is good and its antiinfection ability is strong, which promote the wound healing. The size of flap coverage is relatively large. The mobility of flap is high. The process of operation is safe. The wound can be closed through one operation. So the period of treatment is cut down. The disadvantages of operation are: One of the main arteries of extremities has to be victimized and its supply area will leave scars. The operation indication and opportunity, the selection of operation style were discussed. It also discussed the matters that should be paid attention to during the operation. The photos of typical gabs were attached.

Repair of Wound Defect of the Foot with Axial Flap Transplantation

(Abstract)

Bet Kangsheng, Qiu Wanhong, et al.

The article reported that 27 different bone and tendon exposed wounds of foot were repaired by six kinds of axial flap. The flaps of 26 out of the 27 cases were survived except the majority necrosis of one flap. The survival rate was 96.2%. According to the features of sole tissue, the repaired foot should own good sensation, pressure and rub resistance in addition to its covering by enough tissue. So that the walking and weight carrying function of foot can recover well.

The sole features and flap choice were discussed in the article.

Burning Scar Carcinoma (A Report of 11 Cases)

(Abstract)

Tao Yiexing, Re Xiti, Wang Gongli, et al.

(Dept.of Burns and Plastic Surgery. People's Hospital of Xinjiang)

The burning scar carcinoma is not rare in China. UP to now, there have been 105 cases since the first case was reported by Sun Jianqiu in 1963. 11 cases of buring scar carcinoma was treated in the writer's department from Jun 1977 to Mar. 1990. This paper approaches the clinic showing, pathological types, preventions, early diagnosis and treatment of the burning scar carcinoma.