目录

Burn of the Aged

(Abstract )

Zhang Lin-clang

(General Hospital. BeiiinH Military Reston PLA)

Advances in medical sciences and improvement of living standard result in a growth of the population of the old age. The incidence of burn of the aged . increases. Old burn patients amount to 2 to 16% of the total hospitalized burn patients. The mortality of the burn of the aged is higher.

In this paper, burn index, burn seventy index and burn prognotic index are introduced for assessment of the prognosis of the burn of the aged.

The management of the burn of the aged includes: 1. The relation of the incidence of pneumonia La. and the treatment of respiractory tract burn. 2. Parenteral fluid therapy. 3. Drug administration. 4. Early excission of the scar. 5. Infection control. 6. Nutrition support and 7. Nursing.

In this paper, recent advances in the treatment of the burn of the aged, the causes of death and the relation of death with previous diseases are discussed and finally, a discussion is made on DEBT and MEBO and the possibilities and features of the application of MEBT and MEBO for treating burns of the old patients.

Experimenta.l Study of the Effect of MEBO on Blood Rheology in the Treatment of Burnt Rabbits Rheology in the Treatment of Burnt Rabbits

(Abstract )

Wang Guangshun, et al.

(Tat--an Hospital, China Science and Technology Centre for Burns, Wounds and Ulcers)

Rabbit with 2nd degree burns were divided into two groups. Animals in one group were treated witl , MEBO and animals in the other group were not treate and just had the wounds dry exposed. Blood rheology indices were determined immediately after burned. Apparent blood viscosity and plasma viscosity a different shear rates were determined at different timl intervals. Animals in the group without treatment ha higher viscosity than animals in MEBO treating group. The diff6rence was statistically very significant(P<O.01 ). Blood rheology indices of the animals in MEB treating group had no significant difference(p>0. 05) as compared with that of the healthy animals in thl control group, except for the total blood viscosity at 24 hours after burn in the MEBO treating group was 11.5s-1and that of the healthy animals was 5. 57s-1 and this difference was of significance(p<0. 05). The results revealed that MEBO reduced the evaporaction of the body, improved microcirculation, lessened the erapo raction of the wound surface and the cappilary exudation of the whole body and thus lowered the rheological indices' The results also suggested that for patients slightly or moderately burnt, treated with MEBO at the early stage, no fluid or blood infusion would be needed and for severely burned patients, the amount of the infusion fluid could be appropriately reduced.

Changes in Blood Calcium Concentration at the Early Stage of Burn and the Efficacy of Gal Tian Li for Preventing Hypocalcemia

(Abstract )

Zhang Xiangqing, et al.

(No.139 Hospital PLA, North Shandong Burn Centre)

Clinical research on the change in plasma calcium concentration post burn and the experience in treating hypocalcemia are lacking. Through their clinical observations, the authors discovered that patients with moderate or severe burns often had hypocalcemia. Plasma calcium level began to lower at 48 hours post burn and began to recover only after half a month post burn. If Gai Tian Li was used at the early stage, hypocalcemia could be prevented.

Hypocalcemia at the early stage of burn affects the activity of many kinds of enzymes, the function of blood coagulation, muscular contraction and nerve conduction. Hypocalcemia also induces osteoporosis and affects the recovery of the burn patient at the later stage. The authors suggested that it is necessary to take measures to prevent hypocalcemia for moderately and severely burned patients especially for children.

The Effect of Bacillus Pyocyaneus Lipopolysaccharide Antigen on the Antibody Concentration in the Serum of Burn Patients

(Abstract )

Wang Dechang, et al.

(People's Hospital, Shandonq Province)

5 severely burned patients were treated with Bacillus pyocyaneus lipopolysaccharied. Observations were made on the changes in serum IgG, lgM and IgA antibody concentrations. The results revealed that at early stage of burn (within 2 weeks ), IgG concentration lowered down very significantly and did not recover in this period if no treatment was r conducted. Patients treated with Bacillus pyocyaneus Iipopoly -- sacchartide had their serum lgG concentration recovered rapidly. At the early stage of burn, serum lgM concentration also tended to lower down but could not be recovered significantly by immunological method. No significant change in serum lgA level had be found after burn.

Retrospective Analysis of the Diagnosis and Treatment of Adult Respiratory Distress Syndrome After Burn and Trauma

(Abstract )

Liu Hongmou, et al.

(People's Hospital, Dezhou Perfecture)

Adult respiratory distress syndrome (ARDS) is a severe complication after burn and trauma. ARDS has sudden onset and rapid development and may result in respiratory failure and multiple system organ failure. In order to improve the diagnois and treatment of ARDS, a retrospective analysis of the clinical data of 9 cases of ARDS was made. 3 of them had simple thoracic trauma, 2 had thoracic abdominal injury and 4 had large area burns. Among the 4 cases died, 3 had large area burns. The clinical data revealed that upon hospitalization, continuous blood gas analysis will be very helpful to early diagnosis of ARDS. Blood gas analysis done after occurrence of ARDS often missed the opportunity of treatment because of delay of diagnosis. The authors suggested that early blood gas monitoring is necessary for patients with burn and trauma. The authors proposed a simple method for the diagnosis of ARDS for medical units where blood gas analysis can not be conducted.

Clinical Experience with MEBT in Treating 24 Cases of Burn in Middle East

(Astract)

Du Fuqing

(Medical Team Sent to Middle East by China Science and Technolozv Centre for Burns. Wounds Ulcers )

Nationwide Popularization of MEBT has achieved fruitful succcess. During the period from Feb. to Nov. 1992, the author visited middle east for two times and made clinical demonstrations using MEBT. 24 cases of burn (not including patients with residual wounds ) were healed. The results proved that MEBT is equally effective for treating patients of different races, in different environments and under different conditions. MEBT is scientifically reliable and applicable. Now we have first hand data regarding the treatment of a large number of patients in foreign countries using MEBT. This achievement has laid a good fundation for us to further popularize in middle east and in western developed countries this new revolutionary therapy.

Experience with MEBO for Treating Residual Burn Wounds

(Abstract)

Meng Xianqiu

(Hebei Hospital, Tianjin)

Residual burn wounds recur repeatedly and are difficult to heal. Patients with repeatedly recurred residual wounds are often physically weak. Bacteria in the wounds become resistant to many antibiotics, - therefore, the treatment of residual burn wounds is a difficult problem in burn therapy. The causes of the formation of residual wounds include: improper treatment, refractory infection, the skin flap for transplantation is too thin or poor in quality, deep 2nd degree burn healed with difficulty under pressure and poor wear resistance, etc.

7 cases with residual burn wounds were treated with MEBO. Clinical obeservations proved that MEBT had the advantages of adequate drainage, strong antiinfective effect, healing pormoting effect, analgesic and antipruritic effects and it is simple and easy to perform. MEBT is an'ideal method for treating residual burn wounds.

A Comparison of the Therapeutic Effect of MEBO

(Abstract)

with SD-Ag

Sun Jingli, et al.

(Changchun Municipal Central Hospital)

l20 cases of burn were treated with MEBO and 20 I. cases treated with a suspension of 1% SD -- Ag in bromogeramine solution. A comparative observation was made. The results revealed that MEBO was superior to SD -- Ag in preventing pains, bleedings, articular dyskinesia, wound infection and promoting wound healing, etc.

A Successful Rescue of A Case of Large Area Scald Complicated by Stress Ulcer Using MEBT

(Abstract )

Ning Shuhua, et al.

(General Hospital, China Railway Construction CorDoration)

A patient fell into an alkaline sewage pool at go L for 4 to 5 see and was scalded to 80% BSA. The patient was treated with MEBT upon hospitalization. The patient psaaed the shock stage smoothly. Most of the wounds turned better in 15 days and were getting to heal. The patient did not take care of his diet and was complicated by stress digestive tract ulcer with massive hemorrhage. While expectant treatment was ineffective, exploratory laparotomy was done and duodenal bulbar ulcer with active bleeding was seen at the operation. Hemostasis and repair were done. The incision suture was removed 9 days after operation and the wounds healed by first mention. 3rd degree wounds were autografted with free skin graft 40 days after operation. The wounds healed in 45 days after injured. The authors summarized their experience with MEBT in the whole course of the treatment.

Rescue of A Child with Exceptionally Severe Scald

(Absract )

Liu Jingwen

(Specialized Hospital for Petrochemical Burns,Jiamushi City)

A baby girl, 16 months old, fell into a boiling water pot and was scalded to 60%BSA and had 40% 3rd degree wounds. The baby was treated timely in regular time intervals with MEBO. Appropriate amount of ceftazidine and amikacin was applied systemically in order to control infections. Other rescue measures such as nutrition support,water electrolyte regulation and acid -- base balance. etc were also taken. The baby healed in a month and was discharged from the hospital.

An Analysis of 71 Cases of Severe and Exceptionally Severe Burns

(Abstract)

Ye Zhenwu

(Dept. of Burns, RailwaV Hospital, Dandong City)

The author treated 786 cases of burns (scalds) of various kinds. Among which 71 cases were severe or exceptionally severe burns. All the patients were treated with MEBT except for & of them were treated , with conventional therapy. 3 cases died. 76 cases healed. No residual wound, no scar and no functional disorder had been found. The results were very satisfactory.

An Analysis of the Causes of infection in the Treatment of Burns Using MEBO

(Abstract)

Zhang Qiang, et al.

(No.4 Debt. of Surzery, No. 322 Hospital. PLA)

The authors summarized the causes of infection in the treatment of burn patients using MEBO and concluded that improper use of MEBO, normal skin contaminated by the liquefication product of the wounds and the patients did npt tide over the shock stage smoothly were the main causes of infections. Appropriate precentive and therapeutic measures were suggested.

An Analysis of 244 Cases of Chemical Burns

(Abstract)

Zhou Chune

(Professional Disease Hospital, Zibo City )

This paper reports the clinical experience with MEBO in treation 244 cases of chemical burns. The author suggested that emphasis should be laid on pre -hospitalization treatment and early debriedement. The wounds should be thoroughly washed with water. Systemic treatment and neutralization of absorbed toxic chemicals are also very important. A detailed analysis of the data proved that MEBO was capable of inhibiting the absorption of toxic chemicals and lessening chemical injuries. MEBO partially neutralized the toxic chemicals and promoted dissolution of the.schar. MEBO had the advantages of good analgesic effect, promoting the removal of the liquefied necrotic tissue, keeping adequate drainage, preventing infections, improving microcirculation, preventing progressive necrosis of the stasis zone tissue and inhibiting fibrous tissue hyperplasia. MEBO is suitale for treating chemical burns of various causes, especially for deep 2nd degree wounds. Proper application of MEBO can promote wound healing and lessen the formation of scar.

Diagnosis and Treatment of Fungal Septicemia in Applying MEBT

(Abstract)

Xiang Jihin

(The 2nd Peoole's Hospital, Yueyang )

The main clinical features of fungal septicemia of burn patient receiving MEBT are the following: persistent high fever, shiver, intractable diarrhea, tremelloid stool and frothy urine. Confirmed diagnosis is based on isolation of the fungus. Amohotericin B in conjunction with other medicines is recommended for treating fungat septicemia. in this paper. a discussion is made on the dissemination of the fungus in the wounds by penetrating through living tissue. The author suggested that systemic infection of fungus was mainly due to flora imbalance and misuse of antibiotics and not due to wound surface invasion.

19 Cases of Lower Extremity Vein Ulcer Healed by Using MEBT Using MEBT

(Abstract)

Ge Chuanshen

(Dept. of integrated Chinese and Western Surgery, South Urban Hospital of Chinese Medicine, Shanghai)

19 patients with vein disease involving 20 lower extremities complicated by shank ulcer were treated with MEBO using special method in bandaging, according to the principle of MEBT. The results were very satisfactory. For patients with intractable shank ulcer and large area ulcer. skin grafting was avoided. The results proved that MEBT could be used to heal ulcers and provided a favorable condition for. operation on the lower extremities and improved the aseptic condition for operation. It is, after all, a good preparatory treatment for lower extremity vein diseases.

Experience with MEBO in Treating Orthopedic Wounds and Ulcers

(Abstract)

Qin Weihua, et al.

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

A good remedy. safe and convenient for external use, which has analgesic, antiinflammatory, granulation promoting, necrotic tissue removing and epithelialization promoting effects for healing infected wounds, osteomyelitis, decubital ulcer, abrasion and contusion, etc is long lacking. MEBO is an ideal remedy for this purpose. It possesses all the above stated characteristics. The authors used MEBO for treating 43 cases of various orthopedic wounds and ulcers. The results were very satisfatory.

70 Cases of Cervical Erosion Healed by MEBO

(Abstract)

Zheng Shujiang, et al.

(Health Centre for Women and Children. Zhelimu League,Inner Mongolia)

70 cases of first, second and third degree cervical erosion were treated with MEBO. The results were very satisfactory. Among them 23 cases had first degree cervical erosion, 36 cases had second degree erosion and 1 1 cases had third degree cervical erosion. The age range was 23 to 45 and the average age was 31.4. 23 cases had simple cervical erosion, 24 cases had granular cervical erosion and 23 cases had papillary cervical erosion.

Before application of MEBO, cervical secretion was removed under inspection using a metroscope. MEBO was smeared on sterile gauzes (2cmX2cm ) and applied onto the wounds under inspection using a metroscope. After application of MEBO for 5 to 8 times, the wounds began to be covered with epithelialization. The wounds healed spontaneouslv in 18 to 38 days. The average healing time for first degree erosion was 17.87 days, for second degree 27 days and for third degree 37.91 days. Total average healing time was 25.71 days. Sexual intercourse should not be permitted during the whole course of MEBO treatment, until 25 days after wound healing.

Causes of Burn Wound infections and Counter--measures --A View from Nursing Angle

(Abstract)

Cui Shuhua

(Affiliated Hospital of Binzhou Medical College, Shandong Province)

The author has been engaging for a long time in the nursing of burns and recognized that wound infection is the main threat of the life of burn patient. Infection results in deeDenina of the wound and causes complications such as septicemia and multiple system organ failure, etc. The author analyzed the causes of, burn wound infection and suggested preventive measures.

The Application of Non--Woven Fabrics in the Nursing of MEBT

(Abstract)

Hu Xiaohong

(Dept. of Burn Plastics, the 2nd People's Hospital. Taiyuan City, Shanxi Province)

We have treated 158 patients using non --wover fabrics for sanitary purpose. Non -- woven fabrics helped to solve the nursing problems in the applicatior of MEBT. Non -- woven fabrics helped to remove wound exudates and liquefication products at the early stage of burn and to prevent infections and decubital ulcer, etc.

Nursing Experience in Treating Burn Patient with MEBT

(Abstract)

Zhang Shuzhen

(General Hospital, China Railway Construction Corporation )

This paper summarizes the nursing experience in brun, scald and frostbite patients treated with MEBT. This the rapy has many advantages over conventiona dry therapy and bandaging method. This therapy avoids the use of large amount of analgesics which cause addiction and dependence. This therapy had antiinfective effect. It enables us to treat a large number of burn patients without requiring strictly sterile condition. This therapy is simple, convenienl and easy to perform. The key to the application of MEBT is the technique of smearing MEBO on the wounds. Nursing personnel should grasp the proper dose of MEBO at different stages of the treatment and the thickness and frequency of MEBO smearing, so that MEBO can fully display its effect. In order to shorten healing time and to promote the recovery of the patients, nursing work should be strengthened and attedtion should be paid to the prevention of complications. in this way, MEBT can give very satisfactory results.