目录

Strive For Further Popularization of the Moist Exposed Burn Therapy to the Rural Area and Grass--Root Medical Units

(A SPeech at the Second National Conference on Burns. Wounds and Ulcers)

Qin Xinhua

(Vice Director of the Scientific and Technological Depatheent, Ministry of Public Health)

Dear Leaders、 Experts. Deputies and Comrades ：

The Second National Conference on Burns. Won nds and U Icers beg ins today in Beijing.

On behalf of the Scientific and Technological Deportment under the Ministry of Public Health, I'd I the to extend our sincere congratulations and warm welcome to the attendants.

The Moist Exposed Burn Therapy(MEBT) and its medical technique, the Moist Exposed Burn Ointment(MEBO) and its pharmacV technology arse the major and advanced scientific and technological achievements in the medical field, won by Professor Xu Rongxiang. In the 1950s, the successful rescue of the extensively burnt patient. Mr. On Caikang, indicated China's Burn Medical Science had reached the world level. Now the MEBT and its technique achieved by Professor Xu has fully shown that China's Med ical Science for Burns, Wounds and Ulcers has taken the leading position in the world.

There are four major problems in the International Burn Society : burn wound pains. burn wound infections. burn wound progressive necrosis and post--healing scars in deep second--degree burns. Through hard work and tremendous efforts, Professor Xu Rongxiang resolved these problems and achieved remarkable clinical results. His achievements include: theoretical and rescue technique research in clinical application of MEBT, devolpment research of MEBO's pharmacy technology and application of its technology in production. These resu its reveal the new laws on the burn wounds healing and provide necessary conditions for wide and effective application of MEBT.

Experts have estimated that annual morbidity of burns in China is 2% of the total population. meaning that there are 22 million patients suffering frpm burns and scalds annually, of them 5 % or 1.1 million receive treatment in hospital and the rest are treated at home for slight burns.

To spread Dr. Xu's aehievements. China Science and Technolog Center for Burns, wounds and Ulcers was set up in February 1 989. The establishment of the center was supported and approved by the Scientific and Technological Department. M inistry of Pn hi ic Health.

Now a nationwide network of MEBT has been established with 5.000 hospitals which can receive about 1 50.000 burn patients every Vear, and more than 5600 clinicians have been trained. The application of MEBT has cut down the expenses in treating burn patients by more than a billion of R M B every year.

Along with the development of China's modernization and reform drive. the theory that science and technology is the first productive force has deeply rooted in the heart of the people. Nowadays. people have great respect for knowledge. science and talent. This has produced an unprecedented and excellent circumstance to popularize the new scientific and technological achievements. Our party and government at all levels are taking legislative, administrative, and financial measures to ensure the timely application of the science and technology achievements. The exploration, introduction and application of new science and technology achievements is the key to the promotion of science and technology. It can also help to solve the problem of the disjointedness of science and technology ach ievements and their appl ication.

The Ministry of Public Health has approved a project which will popularize 100 science and technology achievements to the rural area and grass--root units within 1 0 years, starting in 1 991. MEBT and its medical technique is one of the ten major achievements to be popularized this year.

This conference will focus its discussion on the further studies and explorations of the Burn Medical Science and Technology and resolution of the new problems in its application. The exchange of academic results of the new science and technology will be of significance in our futu re work.

May the Second National Conference on Burns. Wounds and U Icers be a great success.

Thank you.

Advances on Mechanisms and Treatments of Post--Burn Immunosuppression

(Abstract)

Lu Zhenwu, et al.

(Debt. of Pharmacology, xiuliang Medical College)

Immune functions are suppressed to different extent post burn. The antiinfective ability of the body decreases. The effects of "malnutrition". "suppressor cell". "suppressor factor" and "nerveinternal secretion--immunity network" may involve in the mechanism of post-burn immunosuppression. The management of post--burn immunosuppression includes debriedement of the wounds, nutrition therapy. immunopotentiation therapy and immunoregu lation therapy. These are the keys to the promotion of immune fu notion.

Morbidity Analysis of 1520 Cases of Burn

(Abstract)

Meng Qingxiang, et al.

(Dept. of Burns, The lst People's Hospital, Mudauliang City, Heilongliang Province)

1520 cases of burn had been treated in our department from 1983 to 1989. A statistical analysis of the cases revealed the characteristics of the distribution of burn accidents in Mudanjiang city. The analysis included sex, age, occupation, area of residence, season, degree of burn, location of burn and causes of burn.

The authors appealed to strengthen the prevention of burn accidents. The prevention measures are based on the results of the analysis.

The Effect of Anisodamine in the Prevention and Treatment of Burn Shock

(Ahoact)

Zhang Xiangqing

(The Scientific and Technological Cent6r for Burns, Wounds and Ulcers, No.91 Hospital of PLA)

Anisodamine is a new kind of anticholine drugs mainly developed by Pharmaceutical Research Institute. Chinese Academy of Medical Science in April, 1965. 654--2 is its tradename.

We have combined anisodamine with fluid resuscitation therapy in the prevention treatment of burn shock since 1978.

We treated 99 cases with the above-- mentioned therapy and comfirmed that patient's urine output increased considerably after application of anisodamine on condition that total intravenous volumes remained at the same level. This result was compared with 68 cases treated with fluid resuscitation thearpy onfy.

Experimental studies on burn rabbits showed that anisodamine can increase effective renal plasma flow. improve blood rheology and blood flow dynamics. reduce water content of burn issues and remove convulsions of arteriolae lround burn wound areas.

The writer is convinced that anisodamine improves microcirculation at the early stage of burn hrough many ways on the basis of fluid resuscitation therapy. It assures adequate blood flow of microcircu lation units. removes or relieves ischaemia and anoxia of tissue cells, and eventually prevents the vicious circle--disseminated intravascu far coag u I ation.

An Experimental Study of Critical Value on Three Common Bacteria inducing Burn Wound invasive infection

(Abstract)

Lee Leeping Ma En--qing

(Depandent of Burn & Plastic Surgery The First Affulat6d Ho8Pital

Heng Yang Medical college)

The Burn Wound invasive infection model was established in rats by comtamination of 15--20% body surface area full--thickness burn with pseudomonas aeruginosa, staphylococcus aureus. E colt, the most common bacteria inducing burn wound infection respectively. On preselected day, six or more in each group of rats were killed with pentobarbital sodium. Heart blood wass immediately aspirated for blood Culture. The burn wound examination including quantitative bacteriology culture and histopathology was performed in divided burn wound biopsy specimens. The results showed that pseudomonas aeruginosa was of more virulent and invasive and more easy blood dissemination. E colt. inversely, was of less virulent and invasive, StaphVlococcus aureus and E col i were more difficult blood dissemination, The critical values of pseudomonas aeruginosa, staphy-- lococcus aureus. E colt respectively were 103. 104and 1 oebacteria / g tissue. It was the conclusion that different species of bacteria required different density to produce burn wound invasive infection.

Key Words f Burnd Wound, Invasive infection. Blood culture, Histopathology, Bacteria f On a ntitati o n.

In Vitro Human Epidermal Cell Culture

(Abstract)

Guo Wenping, et al.

(Dept. of Burn Surgery, The 18t Ameated HOSPital, Xinjiang Medical Coil6ge)

In recent years, in vitro human epidermal cell cult(Jre technique has been developing rapidly. This provides rich resources of skin for patients with large area deep burns We have been experimenting this technique since 1 990 and have achieved a success. Human epidermal cell of different ages and four different cultivation methods have been compared. An ordinary thermostat has been used to replace a carbon dioxide incubator, the later has been commonly used as described by many authors in the literature. An ordinary thermostat has been proved to be as good as a carbon dioxide incubator for this purpose. It is not expensive and easy to be popularized.

Clinical Analysis of loo3 cases of Burn Treated with Moist Exposed Therapy

(Abstract)

Zhao Junxiang, et al.

(China Burns, Wounds, Nanyang Science and Technology Center)

1003 burn patients were treated with moist exposed therapy in our center, during the period from December, 1987 to October. 1990. Among them, the largest burn area amounted to 98% BSA and the smallest 2% BSA. The oldest had an age of 82 and the youngest 4 months. 104 cases had large area burns and 7 cases had exceptionally large area burns. 76.47% of the patients were infants, preschool children and the young. Most of them had small or medium area burns amounted to 80.76% of the total. Deep 2nd degree burns amounted to 40.88%. The more the seventy the less the incidence. Using moist exposed theTapy; the healing time of the wounds was shortened by 6 to 1 0 days. as compared with those treated with conventional therapy. Moist exposed therapy was applied in conjunction with skin grafting in treating deep 3rd degree burns and the healing time was shortened by 7 to 1 2 days. The authors Suggested d ifferent tech n iques for treating won nds of different depths. In addition to local treatment. svstemic treatment is essential for patients with large area burns. F'atients in a shock state should be treated with great care. A good relative isolation environment and an early nutrition support are requ ired. Compfications should be prevented. The above stated requirements are helpful to the success in the treatment of large area burns.

A Survey of the Popularization of Moist Exposed Therapy in Rural Area Health Centers

(Abstract)

Nie Yun, et al.

(People's Hospital,Yunyan County, Sichuan Province)

This paper deals with the possibility of popularizabon of moist exposed therapy in the rural area, by summing up the experience of 48 health centers of the rural area. The authors concluded that patients with small and medium area - burns can be treated in rural area health center and those with large area burns should be transferred to large hospitals.

60 doctors from rural area health center had been trained to master the technique of moist exposed therapy and 391 cases of burn had been healed using moist exposed therapy in the past year.

The authors suggested;

1. Doctors in the rural area health center should be trained to master the technique and the theory of moist exposed therapy. for a short period.

2. Patients with small and medium area burns can be treated in ru raf area health center.

3. Attention should be paid to systemic treatment. room temperature, humid ity, diet, etc.

4. The authors also described how to prevent the formation of scar. and the points for attention in the inspection of the scar.

Clinical Experience with MEBO in Treating so severely Burned children

(abstract)

Wang Guangskuu, st al.

(Dept.of Burns, Ameated Hospital, Taiskan Medical College)

115 children below 12 had been treated in the hospital during the period from June, 1988 to August, 1991. Among them 50 cases were severely burned. The authors described the experience in the performance of transfusion and hibernation therapy at the shock stage. the management and nursing of the wounds. the prevention and treatment of septicemia and nutrition support. 49 out of the 50 cases were healed. None of them died of septicemia.

Moist Exposed Therapy for Treating 60 Burnt Ears

(Ahoact)

Yu Xien

(Hospital for Staff and Workets, Nabbing Corporation of Chemical industry)

60 burnt ears had been satisfactorily healed using moist exposed therapy during the period from June. 1989 to June, 1990.

Causes of burn : 23 patients (41 ears) were thermally injured. 11 patients (19 ears) were chemically burued. 22 ears with superficial 2nd degree burn had an average healing time of 7.1 days and 12 ears with deep 2nd degree burn had an average healing time of 9 days. Only one case had very thin scar. 2 ears with deep type deep 2nd degree burn had an average healing time of 24 days and had thin scar formation and slightly smaller helix. 4 ears with 3rd degree burn had been complicated by perichondritis had to be debrieded for many times. had a healing course of 2 months, and resu lied in deformed microtia.

The author concluded that moist exposed therapy had good analgesic effect and could promote the healing of the wounds.

Experience on the Treadment of Electrical Burn and the Preservation of the Stump Length

(Aboact)

Scan Gulxiang, Zhang Mingski, Bian Yuanguang

(Da ban Chemical Industry Company Hospital)

The authors cured 34 electric arc burn patients with MEBT.

As a result, burn wound pain was relieved and the period of treatment was shortened.

In order to preserve the length of remnant limb as long as possible, they treated 11 cases with both traumatherapy and MEBT, and got remarkable effects.

The authors described the method of the treatment and the characteristics of the 11 electrical burn cases. They also discussed the mechanism of MEBT.

MEBO for Treating Residual Wounds

(Abstract)

Lai Yuantai, at al.

(Dept. of Burns, People's Hospital, Leskan City, Sickuan Province)

15 cases of residual wounds had been satisfactorily healed by MEBO. MEBO moisturized the wound surface. accelerated the removal of the rotten tissue, promoted granulation and epithelialization. As a result, the wounds healed rapidly.

The authors give a detailed description of three typical cases and conclude that MEBO is the best remedy for treating residual won nds thus far.

A Report of 7 cases scalded by Hot Phthanc Anhydride and Complicated by Eczema

(Aboact)

Kong Jin

(Dept. of Burns, The 3rd Hospital of XuZhou City)

7 patients scalded by hot phthalic anhydride were admitted to the hospital. At first, the patients f were treated with dry therapy and were soon compficated by eczema. After moist exposed therapy was applied instead. the patients healed rapidly.

This paper gives the clinical data of the 7 cases and analyzes the causes of the incidence of complication by eczema. Moist exposed therapy is a good method for treating patients scalded by hot phthalic anhydride and complicated by eczema.

The Application of MEBO in Treating Burns complicated by Infections Eczematoid Dermatitisa--A Report of 13 Cases

(Abstract)

Zhou Rongfang

(Department of burn, Affiliated Subei Hospital of YangZhou Medical College)

Infectious eczematoid dermatitis is an allergic reaction caused by metabolic products of bacterial endotoxin. Usually there are chronic infections fesions nearby. Clinically. there are local tissue congestion. swelling. small papule, pruritus. small blister, even pus-pocket, scab and squame. Last year. we cured 13 cases of infections of burn the early stage and infection of ulcerated scar at the late stage. complicated by infectious eczematoid dermatitis. using moist exposure therapy and MEBO. The average time for the eczema and inflammatory reaction to disappear was 4 days. The burn wounds and ulcers cured in 12 days.

Efficacy Observation on the Treatment of suppurative otltis Media with MEBO

(Report on 25 Cases)

(Abstract)

Li Fengyun

(Hospital of Fad De,atheent of Bureau Fourteen, Ministry of Railways)

The writer gained good results on the treatment of 25 suppurative otitis media patients with MEBO.

All of them recovered from illness except 2 cases of recu rrence.

Dr. Li is convinced that MEBO has good analgesic effect as well as spontaneous drainage effect during the treatment. It can also accelerate - burn wound healing and improve local blood circulatlon.

Among 25 cases. the shortest course of disease is 2 years, while the longest is 11 years. The period of treatment is between 15 days and 25 days. The recurrence of two cases happened on the seventh day after withdrawal of MEBO due to upper respiratory tract infection. Further treatment for 1-2 weeks and prevention against influenza after healing were recommended.

2 Cases of scar canceration After superncial scald

(Aboact)

Chen Cunfu, et al.

(No 91 Hospital of PLA)

2 patients with superficial scald had scar canceration, 30 years after injury. Prolonged stimulation and harmful habit of the patient may possibly be the causes of the canceration.

This paper describes the course of the disease and gives valuable suggestions of prevention measures.

A Retrospect of the Treadment of Neck Burn Scar Contracture

(Abstract)

Wang Daxiong, et al.

(Dept. of Plastic Surgery, General Hospital of Beijing Military Region)

This paper retrospects the treatment of 49 cases of neck burn scar contracture and suggests prevention measures and opportune treating time and sums up the experience in the practice of 8 methods used in the treatment. Points for attention during the surgical operation and post operative rehabilitation are also discussed. The authors conclude that the treatment should be simple and not complicated. The patients' requests should be seriously considered. The treating method must suit the actual condition of the scar, in order to get satisfactorV results. Free skin grafting and local flap are commonly used. island flap of muscular Iatissimus dorsi is of first choice for those with severe deformity.

A Knack of Time--Quantity Controlled intravenous Transfusion Technique

(Abstract)

Zhang Lin-clang, et al.

(General Hospital of Beijing Military Region)

Generally, transfusion fluid is measured by drop counting. The droppers are manually made and are not uniform in diameter. Droppers used in different hospitals vary greatly in diameter, Severe burn patients. patients catheterized after venotomy or into a large vein need a long time, constant quantity and uninterrupted supply of fluid. If the fluid flows in too slowly, the supply will be insufficient. If the fluid flows in too quickly, there will be a danger of cardio--pulmonary complications. Now in China, the use of infusion pump is yet difficult to popularize, the measurement of the volume of transfusion fluid remains a problem.

The authors describe a method to solve this problem that is to find out the average number of drops for one mililiter of fluid and calculate the total number of drops needed for a patient in a day. We can control the number of drops needed per minute in a definite time (e.g. 8 or 16 hr). The transfusion can be carried out in a time--quantity controlled way. Oroppers purchased from market can be calibrated to find out the number of drops for one mililiter of fluid and the data can be recorded on a card. When we use the droppers, we do not need to do the calculation again. In this way, droppers available from the market can be used to perform a time--quantity controlled intravenou s transfusion.