目录

Studies on Blood Coagulation Function at the Early Stage of Burns III.. The Management of Hypercoagulability at the Shock stage of Burns

(Abstract)

Zhang Xiangqing, et al.

(Debt. of Burn Research, No. 91 Hospital)

Hypercoagu lability at the early stage of burns has attracted increasingly great attention of the clinicians. This paper reports the results of experimental and clinical studies of the management of hypercoagu labil ity usi ng different methods.

Experimental results f Rabbits scalded to an area of 1 8 to 20% BSA. No resuscitation fluid was appl led. Progressive increase in external thrombus weight' occurred. At 24hr after damage, external thrombue weight doubled as compared with the value before damage. The rabbits were treated respectively with plasma substitute 706, anisodamine combined with normal saline, and normal saline alone. All the three methods of treatment improved the state of hypercoagu labil ity ,though differed in extent. Examination of F value and analysis of variance proved that plasma substitute 706 was the most effective. anisodamine plus normal saline the 2nd, and normal saline alone the 3rd.

Clinical resu its f Severe burn patients had their external thrombus weight and blood platelet aggregation rate in excess of the normal value before administration of resuscitation fluids. After admin istration of an isodami ne and conventional resusciation fluids, the values approached normal in 48 hr post burn.

The authors suggested that the improvement is attributed to the effects of resuscitation fluids which dilate the blood volume and improve microcirculation. The influence of the blood dilution effect of the fluids on hypercoagulability remains to be fu riber investigated.

The Appncation of Alkaline Phosphatase Histologicochemical Method to the Study of the Microvascular Architecture of the Scar

(Abstract)

Tang Shaoming, at al.

(Research Dept. of Plastic Surgery, Zanjiang Medical College)

This paper reports the study of the microvascular architecture of the scar tissue, using zymohistologicochemical " alkaline phosphatase reaction" staining method. Fresh scar tissues from 1 00 patients were collected during operation. The specimens were frozen and cut into slices. After sta in lug, the vascu far wal is of the scar tissue were visualized showing a brown color. The color of the artery and the capillary was darker than the vein and was clearly discernible under microscope. The authors summarized the advantages and disadvantages of the method and concluded that it i$:a good method for use;in the study of mjcrovascular architectu re of the scar tissue.

Cathet6r infections in Burn Patients

(Abstract)

Zhao Dianchang

(Dept. of surgery, Affinated Hospital, shangdong Medical uaiversity)

9 burn patients complicated by septicemia due to infection of catheters during intravenous transfusion. 3 cases died. In order to arouse the attention of the clinicians. such cases are referred to as "catheterization septicemia" Catheterization through the wound, incision of the inguinal great saphenous vein and repeated or prolonged catheterization at the same site may increase the danger of catheterization septicemia. A discussion onfthe management and prevention of septicemia of the kind is presented.

Clinical Experience with Moist Exposed Therapy in Treating 332 Cases of Burn

(Abstract)

Zou Chun-e, et al.

(Zibo Hospital, China Burns, Wounds & Surface Ulcers Centre)

332 cases of burn had been treated with moist exposed therapy. in August 1989 to December 1990. The results were satisfactory. The advantages of the therapy include marked analgesic and antiinfective effects, no scar formation for deep 2nd degree burns. short therapeutic course and high efficacy.

Clinical Experience on the Chemical Burn

(Report on 40 Cases of Chemical Burn)

(Abstract)

Tian Lixue, st al.

(Tongxian Couty Hospital, Beijing)

40 cases treated with the MEBT, of which the largest area of burn was 66% the average area of burn was 16.9% over 72.5%cases had deep II, The results were, for all the 40 cases were cured, for all the rate of death, the rate of wound infection and other complications were zero. The average time of hospitalization was 33.25 days, Otherwise. using old therapy to treat chemical burn cases, the average time of hospitalization was 43 days, As compared with the old therapy. the MEBT had greatly reduced the treating time. The MEBO's property is alkali while it meet acid. and it acid while meet alkalil it has complexing action and active draingeng function. with all the above functions, MEBO can eliminate the remaining chemical matter and effectively reduce the absorbtion of toxin. Through clinical practice. MEBT has a special function in treating with the chemical burn.

Clinical Experience in Treating a Case of severe Muscle and Bone Burns

(Abstract)

Wang Peisheng, et al.

(China Burns, Wounds and Scarce Ulcers, Nanyang Science and Technology Medical Centre)

Severe muscle and bone burns are rare. but difficult to heal. Reports on the application of MEBO in treating severe muscle and bone burns are still lacking. The authors treated a case of severe burn of this kind using MEBO combined with moist dressing. The result was satisfactory. The authors Suggested thet deep burn down to muscle and bone should be incised timely to reduce pressure. Attention should be paid to avoid renal failure. Debridement should be performed timely to prevent esteomyel iiis.

Moist Exposed Therapy for Treating Deep Burns

(Abstract)

Du Zhibiao, et al.

(Burns, Wounds and Surface Ulcers, Science and Technology Centre, Yanzhou Mining Bureau)

This paper reports the clinical results of 41 cases of deep burn treated with moist exposed therapy combi ned with su rg ical operation. The authors concluded that a combined use of drug and lancet could accelerate the liquefication of deep wounds, lighten the damage of the reject reactions and markedly shorten the healing period. Surgical operation did not incresse the formation of scar.

MEBO for Rescue of A Case of Large Area Deep Burn compncated by severe Respiratory Tract Burn

(Abstract)

Wang Qihuai, et al.

(Hospital for Staff and Workers, The PLA Navy, Anqing City, Ankui Province)

Burn management depends upon the area and the depth of burn. Patients are at risk of infections and further injuries as long as the wounds exist. Therefore, wound management is of paramount importance. The authors Successfu fly used MEBO for treating many burn patients. What is especiallV noteworthy is the rescue of a case of large area deep burn complicated by severe resp iratory tract burn.

The patient, male 21. flame ignited area 69.5% BSA. Among which deep 3rd degree burns amounted to 27.5% superficial 3rd degree 20% and deep Znd degree 22% The patient hospitalized 9 hr after burn, in a state of shock with blood pressure undetectable. Antishock measures were taken immediately combined with application of MEBO. The patient was complicated by severe respiratory tract burn. Subcutaneous emphysema occurred in the left chest and abdomen and was diagnosed as penetrating injury of mediastinal trachea. Aerosol oxygen inhalation, active and aided removal of necrotic products from the respiratory tract were performed. The patient's respiration condition improved gradually and subcutaneous emphysema disappeared in 18 days. All the burn wounds healed except for necrotic phalanges which took longer time to heal.

The authors summarized: 1. MEBO is capable of lightening the systemic toxic reactions. 2. It protects the joint activity of patients with 3rd degree burns. 3. Toxaemia. & septicemia can be avoided, if the treatment is carried Out in a proper way. 4. The application of MEBO should be combined with comprehensive treatment such as blood and plasma transfusion. antibiotic administration, and balancing of the nitrogen and water electrolytes.

Moist Exposed Therapy for Treating Chemical Burns

(Abstract)

Liu Lin, et al.

(The 3rd People's Hospital, Xuzhou City)

Chemical burn is a kind of special injury. Improper management of chemical burns would reSult in severe consequences. This paper reports 210 cases of chemical burn treated with MEBO to get satisfactory results. Detailed clinical analysis proved that MEBO has good antiinfective, analgesic, stasis zone tissus revitalizing, healing promoting and scar formation lessening effects. MEBO also prevents absorption of poisonous Substances and further injuries caused bV the poisons and accelerates the dissolution and the removal of the eschar. The results revealed that MEBO has very wide application scope and will bring a brand new era to the treatment of chemical burns.

Clinical Report of 150 Cases of Btirn Treated with Moist Exposed Therapy

(Abstract)

Chen Seen, et al.

(The 3rd Dept. of Surgery, Central People's Hospital, Zhanjiang, Guangdong Province)

The authors treated 150 cases of burn with moist exposed therapy. The results were satisfactory. The curative rate was 98.7% The therapy markedly improved the results in treating large area deep 2nd degree and 3rd degree burns as compared with conventional therapy. Moist exposed therapy gives the clinicians a clear impression that it is quite different from the conventional therapy. fi has the advantages of no pain, no infection and no scar (or very few scars) for deep 2nd degree and 3rd degree burns. The stasis zone tissue can be revitalized. The function of the joint can be restored and systemic reactions can be lightened. Moist exposed therapy requ ires no special facilities and is easy to perform. Therefore, moist exposed therapy is superior to other therapy.

Experience with MEBO for.Treating Residual Wounds of Burn

(Report of one Case)

(Abstract)

Tang Xinming, et al.

(People's Hospitsl, Daozhen Gelo and Miao Autonomous Couaty)

A patient with superficial deep 2nd degree burn amounted to 65% TBSA had been treated elsewhere, before admitted to this hospital. using silver su if ad iazine cream and ski n grafting. 40% of the residual wounds remained unhealed for more than half a year. The residual wounds mainly located in lower limbs. 10% of them were sporadic 3rd degree won nds and the rest deep Znd degree. H lp joint and knee joint could not extend, keeping a flexion angle of about 45. After admitted to this hospital. the patient was treated. at first, with liquid paraffin gentamycin gauze. lithosperm oil and electrotherapy. All the treating efforts proved to be futile. The wounds were repeatedly crusted and systemic infection ensued. The patient was treated with antibiotics for 20 consecutive days. but the infection was not yet controlled. Part of the wounds was treated with Chinese herbs, but the subcrustal empyema deepened to form Suped ficial 3rd degree wounds. At last, MEBO was applied. The pains were alleviated in 5 minutes and the wounds healed in 90 days. The patient went home on foot after healing. The application of MEBO continued at home and the scar softenec gradually. The patient was well recovered and was able to take part in dancing parties, to ride bicycle and even to play basket ball without any difficulty.

Deep Hand Burns Treated with Moist Exposed Therapy

(Abstract)

Zhang Zhenxin, et sl.

(Dept. of Burn Plastic Surgery, People's Ho8Pital, Shaanxi Province)

33 hands deeply burned had been treated with moist exposed therapy. The therapeutic results and the recovery of the functions had been very satisfactory. The authors described in details what the clinicians should do in order to protect the functions of the hands and to lessen or to avoid the formation of scar.

Moist Exposed Therapy for Treating Ear Burns

(Abstract)

Wang Guosheng, et al.

(Rehabilitation Hospital, TDP Research Association, Harbin)

82 patients involving 107 burn ears were treated with moist exposed therapy. MEBO was applied uniformly on the wounds. in treating a few cases with suppurative perichondritis of auricles, the wounds were incised for drainage and were packed with MEBO gauze. The dressings were changed timely. Perichondritis of auricles was controlled and severe necrosis and atrophic disfigurement were avoided. Other measures were also taken to improve the result of the treatment. The authors considered that the depth of the wounds, the pressure effect during the smearing of the ointment and incomplete removal of the liquefied products were responsible for the suppuration of the wounds. After taking care to these factors, the incidence of repeated su ppu ratio n was greatly reduced.

A Comparative Observation of Exposed and Dressed Methods in Moist Burn Therapy

(Abstract)

Yu Xi--en

(Hospital for Staff and Workers, Chemical Industry Corporation, Nanjing)

The author treated 137 cases of burn from June 1989 to May 1990 using MEBO. The results were very satisfactory. A comparison between exposed method and dressed method had been made. Clinical Data:69 males and 68 females. Age range:70 days to 87 years old. Average age; 28.9 years old. 87 cases with burn area < 5% 30 caes 6--10% 18 cases 11--20% and 2 cases 21--48% Depth: Superficial 2nd degree 115 wounds, deep 2nd degree superficial type 30 wounds, deep 2nd degree deep type 11 wounds. 3rd degree superficial type 15 wounds and 3rd degree deep type 1 wound. Results : Healing period : (exposed method group / dressed method group) Superficial 2nd degree wounds 5.57 +1 .73 days/ 6.86+2.18 days, P<0.01, deep 2nd degree wounds 12.46+3.43 days / 15.57+4.71 days, P < 0.05. In exposed method group, among 13 cases of deep 2nd degree sup.erficial type burn, only 2 cases had slight pains, while in dressed method group, among 17 cases of deep 2nd degree superficial type burn, 10 cases had pains, P<0.05. All the patients in exposed method group had no scar formation. while in dressed method group, 6 cases had scar formation, P < 0.05.

The author concluded that exposed method is Superior to dressed method. But in some circumstances, such as at low room temperature, the patients would not be able to endure large body area exposed or for children, who would not be cooperative enough. etc. dressed method should be used.

A Comparative Analysis of the Efficacy of Dry Therapy and Moist Therapy of Burns

(Abstract)

Zhao Deda

(Hospital for Staff and Workers, Jinxi Refinery, Liaoning Province)

The author made a comparison between the clinical data from dry exposed therapy and moist exposed therapy and concluded that moist exposed therapy is superior to dry exposed therapy in many respects. Moist exposed therapy has good analgesic and antiinfective effects and lessens the need for skin grafting and the formation of sear.

A Comparison Between Dry Therapy and Moist Therapy in Treating Burn Wounds

(Abstract)

Zhang Hultang, et al.

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

100 burn patients were randomly divided into two groups and treated respectively with moist exposed therapy and conventional dry therapy. A comparison between the clinical data of the two groups revealed that moist exposed therapy is superior to conventional dry therapy in many respects. Moist exposed therapy had marked analgesic and antiinfective effects. No scar or very few pliable scars formed. No pruritic and uncomfortable feelings. Only very few cases had blisters or pustu ies. Moist exposed therapy is easy to perform and is ideal for family and rural area use. It is worthy to be popularized.

Chronic Ulcers Treated with MEBO

(Abstract)

Zhang Huazhi, et al

(People's Hospital, Rongcheng)

Chronic uIcers are susceptible to bacterial invasions and difficult to heal. The authors used MEBO for treating 20 cases of chronic ulcers of different areas and depths. The ointment was applied in dressings or in an exposed way. Dressings were used in cold winter and to the children who were not cooperative enough to the exposed treatment. All the patients healed. No skin grafting was needed. The healing period was short and no scar formed.

Experience with MEBO for Treating Wounds and Ulcers

(Abstract)

Zou Shuwen, et al.

(Dept. of Burns, Xiangdong Hospital, Hunan Province)

The authors treated 35 cases of wounds and ulcers with MEBO. Among which 6 cases had carbuncles, 8 cases abscess, 4 cases chronic ulcers, 5 cases decubital ulcers and 12 cases abrasions. All the patients healed. The authors proposed that the mechanism of the treatment of burn wounds and that of the ulcers are quite the same. MEBO has the effects of activating the blood circulation and eliminating blood stasis, subsiding swellings and alleviating pains, removing necrotic tissue and promoting granulation. Therefore, MEBO is capable of promoting the healing of the wounds. The incidence of skin grafting can be reduced. MEBO also has antii nfective, microcircu lation improving. necrotic tissue Iiquefying and drainage promoting effects.

Clinical Analysis of 42 cases of Chronic Surface Ulcer Treated with MEBO

(Abstract)

Wang Jihuan

(People's Hospital, Linqu Coullty, Skangdong Province)

MEBO is a new drug for treating burn wounds and has been popularized throughout the country. Reports dealing with the use of MEBO for treating chron ic surface uIcers are sill lacking.

According to the idea of Prof.Xu Rongxiang that burn wound is a combination of all kinds of wounds and ulcers. the author used MEBO for treating 42 cases of chronic surface uIcer. Through his experience, the author concluded that M EBO is very efficacious for treating chronic surface ulcers. It has a short therapeutic course and gives rapid healing. It is acceptable to the patients. MEBO is a new drug with promising prospects in the treatment of chronic surface nicers.

6 Cases of Herpes Zoster Treated with MEBO

(Abstract)

Du fuqin, et al.

(Railway War Preparedness Hospital, Qihe City)

The authors treated 6 cases of .herpes zoster using MEBO. The resuits were satisfactory. MEBO was applied after removing vesicle fluids and the wounds were dressed. The dressings were chsnged once every day. 4 cases healed in 3 days and 2 in 5 days. MEBO has very good analgesic and antiinfective effects. It dilates the micro blood vessels, improves microcirculation and accelerates wound healing. The therapeutic course was short and no scar formed.

MEBO for Treating 32 Cases of Paederus Dermatitis

(Abstract)

Gong Yiping, et al.

(Hospital for Staff and Workers, Hubei Steel Wire Factory)

The authors used MEBO for treating 32 cases of paederus dermatitis. The results were very satisfactory. MEBO had good anal.gesic effect. The healing period had been shortened as compared with the conventional therapy. The lesion area completely healed in 7 to 10 days. The curative rate was 100% None of the patients had scar formation. MEBO for treating paederus dermatitis is worthy to be popu larized.

Shank Chronic Ulcers Treated with Moist Exposed Therapy

(Abstract)

Yu Yipeng, et al.

(Dept. of Burn Plastic Surgery, People's Hospital, Taishou City, Jiangsu Province)

22 cases of shank chronic ulcer had been treated with moist' exposed therapy. The results were satisfatory. The patients were kept in bed with lesion legs lifted. Attention should be paid to the management of the primary fool to avoid varix of great and small saphenous veins. diabetes and osteomyetitis. The authors proved that this therapy is ideal for treating shank chronic ulcers because it is easy to perform and has good efficacy.

A Case of Burn Complicated by Suppurative Perichondritis of Auricle Treated with MEBO

(Abstract)

Li Wenlai

(Dept. of Burns, Xiangtang Hospital, Haicheng City, Liaoning Province)

The author treated a case of burn complicated by suppurative perichondritis of auricle. For lack of experience, the author used antibiotic gauze for treating the wounds in the first time. The result was not satigfactory After debrieded foT .the 2nd time, MEBO was applied. The wounds were packed with MEBO gaullze. The wounds healed fin 26 days. Disfigurement due to microtia and cauliflower ear had been avoided.

Surgical Operation Combined with MEBO for Treating Chronic Anal Fissure

(Abstract)

Zhang Kezhen, et al.

(Dept.of Hemorrhoid and Fistula, The 2nd Hospital, Yanzhou Mining Bureau)

Chronic anal fissure is a common and painfu I disease. The authors treated 53 patients of chronic anal fissure with surgical operation followed by application of MEBO. Another group of 30 patients were treated with surgical operation alone. The MEBO combined treatment group gave better results. The therapeutic course was shortened by one third as compared with that of surgical operation alone. MEBO has the merits of good analgesic and antiinfective effects. It lightens the in jury of the tissue and promotes healing of th wounds.

Disfigurement Due to Scarring Repaired by Skin Dilatation

(Abstract)

Chen Cunfu, et al.

(No. 91 Hospitsl)

The authors repaired 12 cases(10 males and 2 females) of severe disfigurement due to scars'ing using skin dilatation technique. Among which 9 cases had cicatrical alopecia and 3 cases severe faciocervical contracture. All the patients healed. No complication occurred. The clinical experience had been described.

Successful Use of Free Skin Graft with Subdermal Vascular Plexus in 25 Patients

(Abstract)

Huang Hengliang

(Laibin County Hospital, Guangxi Zhuang Autonomous Region)

The authors used free skin graft with Subdermal vascular plexus in 25 patients. The auccessful rate was 96% Only one patient failed to heal. Among them, 8 cases had facial scar, 6 cases chest scar, 4 cases finger scar and contracture deformity, 2 cases foot trauma deformity, 1 case axillary joint scar. 1 case elbow joint scar and 3 cases popliteal fossa scar. The 24 patients were followed up for 4 to 12 months. The post operation skin graft area differed with different recipient sites. Skin graft on the joints extended along the body axis, but shrinked crosswise. The results were satisfactory. The patient who failed to heal was found to have extravasated blood, splitting of the suture and necrosis of the skin graft. The authors Suggested that the failure was caused by incomplete removal of the scar, tension in the Suture, improper immobilization and floating of the flap, etc.