目录

Studies on Blood Coagulation Function at the Early Stage of Burns II. Blood Platelet Aggregation Function and in Vitro Thrombus Weight and the Correlation Between the Two Paramaters

(Abstract)

Zhang Xiangqing, et al.

(No. 91 Hospital)

Blood platelet aggregation function and in vitro thrombus weight of scalded rabbits had been determined. The results revealed that rabbits with second degree burns covering 20% TBSA had hypercoagulability in 24 hours after injury. Blood pjatelet aggregation rate was increased as compared with the data from before injury and with the control animals. The dry weight of thrombus was also increased. Took blood platelet aggregation rate of scalded rabbits as an independent variable and the dry weight of thrombus was a dependent variable. The authors found that when the animats were in a physiological state, prior to being injured, the two parameters had markedfy positive correlation (r = 0.682, P< 0.01 ). linear regression equation y = 1 .971x37.80 and when after being injured. the correlation coefficient r=0.378 (P<0.01 ), linear regression equation y=0.4496x + 19.17. This result showed that thrombosis was accelerated as the platelet aggregation rate increased.

Disseminated intravascular Coagulation

(A Review)

(Abstract)

Zhsng Linxiang

(China Science and Technology Cease of Burns, Wounds and Surface Ulcers)

Disseminaied Intravascular Coagulation (DIC) is a serious disease. Visceral failures with uncontrollable hemorrhage and cell necrosis are the major symptoms. The disease has a mortality of 58 to 81% though its curative rate has been raised recently. This review gives a discussion on the basic knowledge. physiopathology diagnosis and treatment of DIC.

A. Etjology and Pathogenesis:

1. Etiologyt a, angioendothetial injury. b, coagulants entering the blood. .which include (1) tissue coagulation factor, (2) massive destruction of erythrocytes and platelets, (3) other thromboplastic substances.

2. Thromboplastic Factorst a, reticuloendothelial system dysfunction. b. hypercoagulability. c, decrease in fibrinolysin concentration, d. blood stasis, e, acidosis.

3. Factors affecting the. seventy of DICf a, inducing factor, b, amount and velocity of the thromboplastic substances which enter the blood, c, original concentration of coagulants in the blood. d. other factors such as the function of the reticuloendothelial sVstem, vascular bed and hemodynamics. etc.

4. Pathogenesis f which includes the courses of blood coagulation and fibrinolysis. a, blood coagulation, (1 ) external and internal thromboplastin generation, (2) thrombinogenesis. (3) fibrination. b, fibrinolysis (1 ) generation of kinase. (2) generation of fibrinolysin, (3) fibrinogen degradation products and fibrin degradation products..

B. Climcal Manifestations:

1. Acute, 2. subacute and 3. chronic types. Symptoms and signs of DIC a, embolism, b. spontaneous hemorrhage. c, shock and d, hemolysis.

C. Causes of Disease:

1. Transfusion reaction, 2. massive transfusion of obsolete blood, 3. infection. 4. fat embolism, 5. crush syndrome and severe large area burn, 6. obstetrical severe complications, which include a, premature separation of placenta. b, amniotic embolism, c. retention of dead fetus. d. induction of labor by hypertonic saline. e, toxemia of pregnancy. 7. podiatric diseases, which includea. diseases of new--born, b. purpura fulminans. c. infantile hemolysis/uremic syndrome. 8. mal ignant tumor, 9. hepatopathy. 10. massive tissue injury and brain tissue'destruction, 11. other diseases.

D. Diagnosis :

Mainly on the basis of clinical manifestations and laboratory examinations. Early observation and examination are urged.

1. clinical manifestations a, blood coagulates in syringe as it is drawn from the vein, b, sudden occurrence of multiple embolism or hemorrhage. c, bleeding difficult to stop or the clot is very loose. d. shock not recovers after treatment and turns into refractory shock, e.' occurrence of ARDS, ARF or acute adrenocortical failure with exctUsion of other diseases. f. hemorrhage of unknown cause or worsening of the case of anemia with fragments of red cell in the blood.

2. Laboratory Examinations a, screening test. b, fibrinolytic function test and other tests if possible.

E. Treatment:

Treatment of the primary disease is very important. Treatment at different stages :

1. At the hypercoagulability stage, anticoagulants and antiplatelets are applied, a. heparin, b, low molecular weight dextran. c. persantin and aspirin, d, scopolamine and e. coumarin for chronic DIC.

2. Consumptive hypocoagulability stage a, heparin and b. persantin. aspirin, dextran and scopolamine, c. blood coagulation factors such as fresh blood. fresh cryodessicated plasma, blood platelet concentrate, fibrinogen and other factors e.g. Factor II.V, and X, d. fibrinolytic agents Such as streptokinase, e. tissue type plasminogen activator.

3. secondary fibrinolytic stage. mainly at the late stage of DIC. a. the treating scheme is the same as for consumptive hypocoagubility stage. b. antifibrinolysin. c, heparin. 6-aminQ hexanoic acid. p--aminomethyl--benzoic acid, transamic acid and trasylol.

4. Fibrin degradation product anticoagulation stage, Foci and causes of the disease are removed using heparin therapy, antifibrinolysin therapy. blood coagulating factor therapy and protamine if necessary.

A Survey of Blood Type and Psychological Characteristics of Burn Patients

(Abstract)

Chen Cunfu. et al.

(No.91 Hospital)

This paper describes the interreletionship between blood type, psychological characteristics and the incidence of burn injury. according to a survey or 1100 cases. The normal proportion of the distribution of blood types in healthy people is also reported. The proportions of B type blood in healthy people and in burn patients differ greatly. The incidence of burn injury is much higher in people with B type blood. Factors concerning the greater possibility of being burnt were d iscussed.

124 Cases of Burn Treated with Moist Exposed Therapy

(Abstract)

Zhao Rulqing, et al.

(The 2nd People's Hospital, Taiyuan)

124 cases of burn, among which & cases with exceptionally large, 29 cases with large and 87 cases with medium area burn,were treated with moist exposed therapy. The therapy has its advantages of having good analgesic and strong antiinfective effects and low incidence of complications. It needs only a small amount of transfusion fluid and promotes the recovery of the stasis zone tissue. When liquefaction is almost complete, MEBO can be applied in company with non--adhesive medical gauze to alleviate pains during the smearing of the ointment and to facilitate healing of the wounds.

115 Cases of Burn Treated with Moist Exposed Therapy

(Abstract)

Wang Zhiping, et al.

(No 242 Hospital, PLA)

115 cases of burn. among which 60 cases with severe and moderate burns. had been treated with moist exposed therapy. All the patients healed. No septicemia occurred. No skin. grafting Needed. No functional disturbance and no scar formation occursed, except for full--thickness burn wounds. The results proved that this therapy is simple and easy to apply. It has analgesic and antiinfective effects. It promotes healing and protects the functioning of the wounds. It is not expensive and is easy to be popularized.

Clinical Experience with MEBO in Treating Face Burns

(Abstract)

Ren Baifang

(No. 405 Hospital Penglai City, Sbandong Province)

Face is the exposed area of the body surface. Face burns occur frequently and often result in scar formation or demormity, when treated with conventional therapy The author treated 32 cases of face burn us-' lug moist exposed therapy. All the patients healed. The skin growth and its appearance were very satisfactory. Moist exposed therapV had analgesic effect. It prevents infection of the wounds. There was no scar for deep second degree burn. The ljquefaction was completed in 12 to 1 6 days. All the patients healed with normal facial appearance without scar formation.

A Child with Exceptionally Large Area Burn compncated by Septicemia Cured by MEBO

(Abstract)

Wang Peisheng, et al.

(China Barns, Wounds and Sauce Ulcers, Nanyang Science and Technology Medical Center)

This paper describes in details the course of the treatment of a child with 92 %TBSA burn (over 80% fulf--thickness burn) and compticated by septicemia, using moist exposed therapy and the drug MEBO. The child healed. Detaifed procedure )f of bandaging with MEBO and related probfems were discussed. The authors suggest that the my feeted wound shoufd be thoroughly debrieded bee fore bandaging with MEBO and systemic treate ment is of crucial importance to the patient.

An Analysis of 25 Cases of Cranial Electric Burn

(Abstract)

Jiang Tingyin, et al.

25 cases of craniaf etectric burn were treated from March. 1963 to May, 1989. in four units of Shandong Province, of which 23 were males and 2 females. with and average age of 18. Most of them were young people or children. The burn involved the forehead (2 cases). the top (15 cases). the tempore--pental june.ture (5 cases) and occipito--pental juncture (1 case). There were 3 cases of necrotic extremities. 1 case of enterocele due to necrosis of ail the abdominal wails, 1 case of vescical--abdominat fistula and 8 cases of multiple lesions.

Because of the features of the anatomical structure of the scalp, most cramal electric burns led to total necrosis of the scalp. the defluxion of which made the crania long uncovered. thus serious intracranial compl ications often occurred. The grafted skin is easy to survive after the formation of granulations by drilling the dry crania. The necrotic crania of total laminae must be drilled through. leaving a space of 1.0 to 1.5cm between each two openings. The necrotic crania soon separate from the fundus and are easily removed. Simple necrotic external slabs are also easily detatched from the soft tissue and the skin--grafting can be done soon after the granulations are noned together to heal the wounds. This is a good method for treating cramal electric burn. For post--cramal electric burn, the approximal skin flap can be used to close the wounds.

An Analysis of 15 Cases of Phosphorus Burn

(Abstract)

Song Xianchun, et al.

(Dept. of Surged, No. 59 Hospital, PLA)

15 cases of phosphorus burn, among which 4 cases with tabed degree burns, the largest burn area 23%TBSA, were treated.

Clinical manifestations: At the early stage, smoke rose from the wound with garlic--like odour. There were burn holes in the wound. Erythrocytic Proteintria, jaundice, lung injury of mental symptoms occurred in some severe cases.

Early treatheat: Wadded with water and 1% sliver nitrate solution was applied. Thorough removal of the residual phosphorus shoed be ensured. If necessary, Phosphorus manacles should be picked out in dark room. Early escharotomy and skin graft are advisable. Great attention should be paid to complications if encountered.

All the patients healed with an average hospital stay of 23 days.

Efficacy Analysis of the Treatment of Chemical Burns

(Abstract)

Chen Cunfu, et al.

(No. 91 Hospital)

This. paper reports the clinical experience in treating 26 cases of chemical burn with MEBO. The authors suggested that superficial chemical burns can be healed by various conservative therapies. Pain in the burn area is the major abnormality and can be alleviated or stopped by using MEBO. Deep second degree chemical burn of the finger and dorsum of the hand, etc. are the best indications of MEBO. MEBO works in the wound area forming "an automatic assembfy line" to keep adequate drainage of necrotic tissue. It prevents secondary injury of the burnt tissue and thus results in good healing. The treatment of deep third degree chemical burn remains to be further investigated.

2 Cases of Refractory Ulcer Healed by Treating with Moist Exposed Therapy

(Abstract)

Hui Lei, et al.

(Hospital for Staff and Workers, Kaifeng Kongfen Equipment Factory)

2 cases of refractory ulcer cured by treating with egoist exposed therapy. The ulcer areas were 4 x 5 cm2 and 11 x 14 cm2. After treated with MEBO. the ulcers healed in 90 and 170 days respectively.

cnnical Experience in Treating skin ulcers with Moist Exposed Therapy

(A Report of 4 Cases)

(A6stract)

Chen YinZhong

(People's Hospitsl, Yunckeng Prefectal, Sbauxi Province)

4 cases of skin ulcer, one burnt and compficated by crush injury, one with wounds kicked by animal. one with wounds due to radical operation of breast cancer and one with leg nicer due to varix of lower limb. The wounds did not heal for 50. 37 and 18 days and 7 months respectively. After admitted to hospital and treated with MEBO.the wounds heajed in 27,19, 23 and 29 days respectively. The therapy has its advantages of having antiinfective effect, promoting drainage and blood circulation and thus facilitates the healing of the wounds. The patients can be treated at home as well as in hospital.

50 Cases of Local Ulcer Treated with MEBO

(Abstract)

Guo Quail

(Town Hospital, RuZhou City, Henan Province)

According to the theory advanced by Prof. Xu Rongxiang that burn wound is a combination of all kinds of trauma and surface ulcer..., we attempted to appfy the moist exposed therapy to patients with surface ulcers. 50 patients were cured. "The efficacy was very amazing.

The author concluded that the moist exposed therapy has three advantages. namely, it is capable of promoting the healing of the wound. it is antiinfective and it has marked analgesic effect. The author highly appraised the drug MEBO to be the most effective drug for treating surface ulcers at present.

A Case of Large Decubital Ulcer Healed by MEBO

(Abstract)

Pan Fuwen

(Dept. of Surgery, People's Hospital, Haikou City)

Ye xx, male 75. was admitted to the hospital on March 31. 1990. Fracture of the neck of femur occurred a month before hospitalization. The patient was unable to turn over in bed and resulted in sacrococcygeal decubital ulcer. The ulcer had been treated with Chinese herbs. It did not heal and was infected. The ulcer was irregular, deep and wide. with hollow center. Sacral preiost was exposed. The exposed area was like the size of a 5 cent coin, the longest 31cm and the widest 22cm. The ulcer was full of pus with ill--smelling. The granulations were not fresh. Debriedement was performed 3 days after washing away the necrotic tissue and systemic treatment with antibiotics was followed. The application of MEBO commenced a week after debriedement. The ulcer healed in 12 weeks. No scar formed and no skin grafting needed.

Efficacy Analysis of MEBO for Treating Herbes Zoster

(Aheact)

Tan Yi, et al.

(Dept. of surgery, Affinated Hospital, school of Hygenic science, wan county, sichuan Province)

5 cases of herpes zoster were treated with MEBO. The results were very satisfactory. The ointment has good analgesic and antivirus effects. It promotes the healing of the wounds. The comparison between the results of MEBO and the result of one case treated with calamine proves that MEBO is superior to calamine.

A Case of Refractory Face Tuberculoderma Cured by Moist Exposed Therapy

(abstract)

Li Shuwen, at al.

(Hospital for Staff and Workers, Ckangckun Optical instrument Research Institute, Chinese Academy of Science)

This paper reports a case of refractory face tuberculoderma (more than 10 years) Cured by moist exposed therapy. The skin of the face after recovery is intact and the scar is softened, leaving very slight pigmentation. Clinical practice proved that moist exposed therapy is not only effective for treating burn wounds, but also very efficaciuos for chronic refractory dermatosis.

MEBO Used for Treating Padiatric Drug Dermatitis

(A Report of 2 Cases of Purpura Form Dermatonecrosis)

(Abstract)

Zhou Rongfang, at al.

(Dept. of Burlls, Ameated North Jiangsu People'8 Hospital, Yangzhou Medical College)

Padiatric drug dermatitis-- purpura form dermatonecrosis is rare ic clinic. We treated 2 cases using MEBO in 1990. MEBO is as effective for treating skin necrosis as it is for treating burn wounds and ulcers. MEBO helps to keep adequate drainage. alleviate imflammatory reaction, increase local blood flow and improve microcirculation without toxic side effect. It is very efficacious. One patient healed in 14 days and the other 10 days.

Application of MEBO to skin Grafted wounds

(Abstract)

Wang Junxing

(No. 257 Hospital, PLA)

10 patients with deep second degree and third degree burns. burned area 5 to 23% TBSA. were treated. Escharotomy was performed on the fifth day after burn and followed by skin graft. After operation. the Wounds were bandaged with sterile dressing for 48 hours. Then the dressing was removed and MEBO was applied 3 to 4 times every day. The space between flaps healed quickly. The tissue scar reaction was markedly lightened. The healing period had been shortened by 7 to 10 days as compared with the conventional therapy.

Observation on Skin Appendages of Full--Thickness Burn Wounds at the Repair stage and the APPncation of 10% Sulfur Ointment

(Abstract)

Cul Guanghuai

(Dept.of Burns, Affinated Hospital, Binzhou Medical college)

180 cases of full--thickness burn were treated with moist exposed therapy. Secretion accumulation with small herpetiform changes in the wounds had been observed in 12 cases. Most of them occurred in head. neck and four limbs. Pathological examinations proved that the changes occurred in the epithelial tissue with hyperkeratosts and keratin pearl. The existence of gland bodies had been proved.

The author suggested that when accumulation of gland bodies appears, it indicates the complete repair of the tissue. For deep second degree and superficial third degree burns, if skin grafting is performed too early to close the wound. it will result in greater pains to the patients. The author also suggested that the accumulation of gland bodies is due to overgrowth of the epidermis which covers the sebum and the sweat glang cell and hinders the drainage of gland excretion. and is also due to improper treatment of the wounds, etc.

The author applied 10% sulfur ointment and sesame oil alternatively on the wounds. The accumufation of secretion disappeared in 1 to 2 days and the won nds well healed.

Lateral Myocutaneous Flap of Trapezius Muscle

(Abstract)

Fang Doughal, et al.

(Kunming General Hospital, Chengdu Military Region)

Yuan lin, et al.

(Department of Anatomy, The Fact Military Medical University)

Since 1985. We used transposition of lateral myocutaneous flap of trapezius muscle with vascular or muscular pedicles, on the basis of anatomical study, for treating 8 cases with severe cicatrical contracture in neck after burn injury, with satisfactory results.

The anatomy. clinical cases, operative designs and procedures are introduced, and the operative methods and clinical applications are discussed.

(key words) myocutaneous flap. trapezius muscle. transposition.

Clinical Application of Dorsal Antebrachial Posterior interosseus Artery Retrograde Island Flap

(Abstract)

Song Jisue Song Jisue

(Central Hospital, Siping City, Jabing Province)

This paper reports the application of dorsal antebrachial posterior interosseus artery retrograde island flap. The flap contains constant amount of tubes and is rich in cutaneous branches. it has large surface, good blood flow, appropriate thickness and good quality. Its cofor is very similiar to the cofor of the hand skin. The operation is very simple with high rate of success. It needs no sacrifice of major artery in the forearm. This operation is ideal for surgical purposes.

Repair of Hand Contracture Deformity After Fun--Thickness Burn

(A Report of 116 Cases)

(Abstract)

Chen Cunfu, et al.

(NO. 91 Hospital)

116 cases of hand contracture deformity. involving 213 fingers. after full-thickness burn were repaired using five d ifferent methods. For oh ildren, lateral digital flap transposition repair gave very satisfactory results with good restoration of the function. The recurrent contracture was markedly lightened and repeated operation avoided.

A Protsctor for Use in Moist Exposed Therapy

(Abstract)

Guo Wenping, et al.

(Dept. of Burns, First Ameated Hospital,Xinjiang Medical College)

Moist exposed therapy has very good efficacy, but the ointment used in the therapy bedly stains the beddings. The authors invented a new protector. It is portable and transparent with good ventilation. It can be used to protect the beddings from being stained. It does not hi nder the activity of the joints. It is very easy to be put on and taken off. The smearing of the ointment, the washing and the disinfection of the wounds can be performed with the protector on.