目录

Three Elements in Burn Medicine Prevention, Treatment and Rehabilitation Prevention, Treatment and Rehabilitation

(Abstract)

Zhang Lins

(Burn Centre, No. 139 Hospital, PLA)

Burn medicine is derived from surgical medicine. It comprises three elements namely burn prevention, burn treatment and burn rehabilitation. 1. The social value of burn prevention:

An analySis of the present status of burn morbidity and the level of burn treatment shows that burn prevention is not emphasized as much as the prevention of other diseases such as infedive diseases and coronary heart disease, etc. A nationwide measure or guidance to the prevention of burn is still lacking. It is why burn morbidity is increasing annually. Once burn accident happens, it is a disaster to the victims and their family and is a great loss of the society. It is not only a physical and economic disaster but also a mental hard knock. The social value of burn prevention is to minimize burn accidents and to protect People from being injured. II. Recent trends in burn treatment:

Both western burn medicine and Chinese burn medicine have their drawbacks. The most important due is that they consider the treatment of burn wound infusion as their ultimate aim and neglect the basic law of wound healing. Moist exposed burn therapy (MEBT), to certain extent, fills in the gap. MEBT is a nelw burn medicine. It combines the merits of western and Chinese burn medicine. Moist e-cpcs6d burn onment (MEBO), a new drug for use in MEBT, has its characteristic features. It is inevitable that the ideas of conventional burn therapy is to be replaced by the new ideas of MEBT.

III. Burn rehabilitation:

Disablity is a serious problem. According to WHO, almost 10% of the world population are handicapped. In which burn viCtims account for a large percentage. When burn wounds heal, it does not mean the patients are really recovered. Physical and mental disturbances will long make them afflicted. Researches on the metabolism of acute burn wound .have achieved a great success in improving the treatment and the prevention of burn complications and the survival rate of burn patients has been raised. Scar formation post--burn is still a difficult problem. MEBO has its miraculous effect for preventing scar formation and for healing scars. The mechanism of its action remains to be further investigated The three elements in burn medicine should not be separated. Only after a better integration of the three elements could a more advanced and perfected burn medicine be established.

The Micro--Mechanism of the Action of MEBO

(Abstract)

Du Huaien

(Hospital of Automobile Transportation Corporation, Liaocheng Prefecture, Shandong Province)

-- Sitosterol and obaculactone are the main active constituents in MEBO. The author elucidated the micro--mechanism of the action of MEBO on the basis of the Chemical structure of its active constituents and pointed out that these chemical constituents have selective adsorptive effepts on bacteria. They moisturize the wounds and promote spontaneous drainage. The intermolecular adsorption and the interaction between the active molecules and the wound exudate can be elucidated by their colloidal property and the strength of different chemical bonds.

194 Cases of Face, Perineal and Buttock Burns Treated with MEBO

(Abstract)

GOng Liansheng, et al

(Dept. Burn Plastic Surgery, Affiliated Xieqya Hospital, Hunan Medical University)

Face, perineal and buttock burn wounds are difficult to handle and their treatment is rather complicated. To what degree the wounds heal, directly determines the recovery of the function and the appearance. The authors treated 194 cases of burn of Such kinds and the results were very satisfactory.

In summing up their experience, the authors point out the followina:

1. MEBO should be applied early to avoid deepening of the wounds.

2. Oebridement should be done timely to avoid infection of the wounds.

3. Promote early closure of the third degree burn wounds to minimize scar formation.

4. Encourage the patients to limber up the joints to avoid scar contracture.

A Comparative Study on Moist and Dry Therapy in the Treatment of Burns of Functional Positions

(Abstract)

Zhu Yingtai, et al

(Dept. of Burn Plastic Surgery, No. 223 Hospital, PLA)

The authors trested 254 cases of medium or small area burns on face, neck and four extremities using moist exposed therapy. Meanwhile 120 cases of burns of the kinds were treated with dry therapy. The therapeutic results were compared. It revealed that moist -exposed therapy is superior to dry therapy for its good analgesic effect, short healing time, little residual scar and good recovery of the functign.

Anti--Shock Measures for Burns Treated with Moist Exposed Therapy

(Abetract)

Liang Ming

(Dept. of Surgery, The 2nd People's Hospitsl, Datong City)

The author treated 50 cases of burn using moist exposed therapy. The largest burn area was 96% BSA and the smallest 20%BSA. 50% of the patients were adults and 50% children. Pediatric patients had the largest burn area of 60%BSA and the smallest 5%BSA. The total healing rate Was 96%. 4 cases died. In this paper, the author suggested anti --shock measures suitable for use in moist exposed therapy and made a discussion on fluid infusion, shock monitoring and other problems.

Perishock Stage Treatment of Burn Patient with Moist Exposed Therapy Exposed Therapy

(Abstract)

Li Fengchun, et al

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

Burn patients, at the shock stage, if are treated with moist exposed therapy, it is important to avoid copying the experience of conventional dry therapy in fluid infusion, otherwise the infusion would be in excess. Based on their own experience with moist exposed therapy, the authors presented fluid infusion formulas for use in moist exposed therapy. 110 cases of severe burn had been treated using the formulas.

Infusion volume and the proportion of colloid to crvstalloid

1. For adults:

Infusion volume=area X body weight X 1. 2ml + 1500ml of basic water volume

Colloid = area Xbody weight X 0. 7ml

Crystalloid = area X body weight X O. 7ml

2. For children:

Infusion volume = area X body weight X 1. 5ml + 50 to 70 ml of basic water volume per kilogram of body weight

The proportion of colloid to crystalloid = 1 to 1. 5

46 Cases of Nasal Vestibulitis Treated with MEBO

(Abstract)

Huang Ongshan, et al

(Urban Central Hospital, Laiwu City, Shandong Province)

46 cases of nasal vestibulitis were divided into two groups. Patients in one group were treated with MEBQ and patients-in the other group were treated with 1% y6llow mercuric oxide ointment. All the patients treated with MEBO healed in 10 days (average healing time) with no recurrence. 87. 5% of the patients treated with l% yellow mercuric oxide healed in 12 days (average healing time). 5 patients had their disease recurred in 6 months. The difference of the therapeutic effects between the two groups was significant.

MEBO for Treating 30 Cases of Herpes Zoster

(Abstract)

Wang Jifeng, et al

(Hospital for Staff and Workers, Yanzhou Mining Bureau, Shsntlons Province)

30 Caacs of herpes zoster were treated with MEBO. All the patients healed. The longest disease course was 9 days and the shortest 3 days. Clinical observations proVed that MEBO had good analgesic, antiinfrective and healing promoting effects. It is worthy to be popularized.

MEBO in Combination with PIC for Treating 25 Cases of Herpes Simplex Comeal Ulcer

(Abstract)

Huang Qngshan, et al

Hubs Qngshalt, et al

(Dept. of OPhthaimology, General Hospital of Laiwu iron & Steel Works. Shandong Province)

25 cases of herpes simplex comeal ulcer were treated with MEBO in combination with PIC. The healing rate was 96% and the healing time 18+0. 66 days. PIC alone was ussd for treating 30 cases of the disease as a control group. The healing rate was 70% and the healing time 23 +0. 98 days. The difference between the two groups was very signifiCants MEBO had the effects of promoting the healing of the ulcer, lessening the local reaction and preventing infections. After applying MEBO, the comeal opacity was very slight and the eyesight improved very qUickly.

Long Unhealed Hand Wounds Treated with MEBO

(Abstract)

Ren Bat fang, et al

(The lst Dept. Of Surgery, No. 405 Hospitsl, Penglai City, Shandong Province)

78 cases of hand wounds with large area skin necrosis and exposure of muscle tendon and bone. The wounds did not heal for long. Atter treat6d with MEBO, the wounds healed very satisfaCtorily. MEBO protected the wounds and had antiinflammatory effect. It created adequate drainage in the wounds. The application of MEBO was very simple and easy. The inspection of the wounds was easily done. No strict sterilization was needed.

Application of Parumbilical Skin Flap in the Repair of Upper Extremity with High--Voltage Electric Burns

(Abstract)

Luo Chengqun, et al

(Dept. Of Burn Plastic Surgery, Affiliated Xiangya Hospital, Hunan Medical University)

Parumbilical skin flap was used in the repair of 7 cases of upper extremity with high--voltage electric burns. 6 males and I female. 3 cases had repair of elbow joints, 3 forearms and wrist ioints and 2 thumbs. All the flaps survived. Disablement was avoided and the appearance and the recovery of the functions were very good.

In this paper, the authors describ6d the design of the skin flap and the method of operation. It was very easy to anatomize and to transfsr the flap. The ' operation was very simple. The aUtoes concluded that this flap is ideal for the rapair of deep defect of upper extremity soft tissue, especially for the repair of upper extremity with high--voltage electric burns.

s26 Cases of Cicatricial Baldness Treated with An Improved Technique of Soft Tissue Dilation

(Abstract)

Tang Diancheng, et al

(asian Municipe Burn Denter, Liaoning)

The authors treated 26 cases of cicatricial baldness using an improved soft tissue dilation technique. The largest bald area was 9. 5cm X 1. 3 cm. The results were satisfactory. Instead of placing the injection pot and dilation bag into the soft tissue, the injection pot and the connecting tubes were outlaid. The operation was very easy and had no pains. Very few complications had occurred after operation. This technique is ideal for treating cicatricial baldness.

Finger Lateral Retrograde island Flap for the Repair of Finger Tip Soft Tissue Defect

(Abstract)

Li Tianyu, et al

(China Burns, WOunds and Ulcers Science snd Technology Centre of Nanvang)

11 cases of finger tip soft tissue defect were repaired by using finger lateral retrograde island flap. along which, 6 cases had acute finger wounds, 3 cases had finger joint bone exposed post burn and 2 cases had distal finger joint muscle tendon exposed after scar removal. The donor site was on the lateral side of the root of the wounded finger. The smallest flap size was 1 cm X 1.5cm and the largest 2 cm X 3cm. For free toll thickness skin transplantation, the donor site was the forearm of the wounded extremity. Suture was done directly after taking off the skin flap.

The operation was easy and the survival rate of the flap was high. The wounds could be repaired by one operation only. The disease course was short with no need for fixation of the finger. The donor site was easily covered up. This flaps is Superior to pedicle flap for the repair of finger tip soft tissue defect.

Ultrathin Skin Flap for Repairing Hand Wound Skin Defect and Scar Contracture Deformity

(Abstract)

Yang Dong, et al

(Dept. Of Burn Plastic Surgery, No. 209 Hospital, PLA)

Ultrathin skin flap with vascular net underneath the semis is a new skin flap recently developed for surgical- use. The flap is easy to operate and has good survival rate. It is soft and not cumbersome . and has good appearance. its pedicle breaks early.

The authors treated 54 cases of hand skin de fed and scar contraCture deformity using this flap. The successful rate was 100%.

One Case of Burn Scar Scalp Cutaneous Horn

(abstract)

Yang Shunbing, et al

(People's Hospital, Xinkuang County, Hunan Province)

A female had a Cutaneous horn grown on the scalp for more than 2 years. When she was 1. 5 years old, her vertex was burned and healed with scar formation. Her hair did not grow in the burned area. Repeated ulceration occurred by frequent abrasion and scratching and did not heal for long. In 1980, a corn grain like hard body formed in the comer of the scar and grew quickly since 1982.

Inspections upon hospitalization showed that the scar on the vertex had an area of 16cm X 17cm, no hair grown there. There was a lump 7.5 cm high with a base circumference of 18 cm. It was dark in color. Longitudinal stripes appeared on the surface. It was hard and not movable. The cutaneous horn connected with the cramal bone (proved by Roentgenogram ). The horn was removed by operation. It was 7. 5 cm in length and 106 grams in weight. No invasion was found in the cramal bone. Examination of the pathological section proved that it was vertex cutaneous horn.

Bacterial Examination on the Surface of Articles Used in Burn Wards

(Abstract)

Cul Shuhua, et al

(Rehabilitation Centre, Bingzhou Medical College)

Artides used in burn wards for 180 days were examined on their surface. The sterilization efficiency was checked by bacterial culture method. The authors suggested that the causes of bacterial infeCtions are:

1. baCteria in stasis zone tissue,

2. bacteria in wounds and periphearal healthy tissues,

3. hospital infections and

4. endogenous infections.

Sterilization methods for various articles were presented.

A Multiple Function Box for Body Temperature Determination

(Abstract)

Li Youhua, et al

(No. 145 Hospital, PLA)

Determination of body temperature and pulse is essential for nursing work. Cinical thermometers, stopxwatch, record paper, photo electric cell, etc. are always necessary. It is very inconvenient to carry so many things with two hands. The authors . designed a box with all these necessities orderly inside. It includes photo cell, sterilized clinical thermometers and thermometers after used in separated positions, stop -- watch, record paper, etc. This box has been proved very convenient for clinical use.