目录

A Great Historical Turn in the Burn Medical Science

Whether in war or in peace, once burns (includ lug th trinal injuries) occur, people will natu rally be led to have resort to the therapy. which is to keep a burn wound dry. The method has beed employed for decades, and considered both at home and abroad to be the only effective means so far available. Now with his Moist Burn Medical Science (hereinafter referred to as MBMS) Xu Rongxiang has challenged such a conventional therapy and demanded to put a stop to dehydration in the treatment of burns. His challenge is fortified by a new medical method he hos invented. which is by contraries to keep a burn wound moist yet not macerated. At the First National Meeting of the Moist Burn Medical Science held in Beijing in December. 1988. the method was declared greatly successful by the experts. who have put it in practice. Its success marks the start of basing the burn treatment on the Cure of the injured tissue, and has brought a new phase in the burn medical science.

The historical setting from which MBMS has emerged

In the world history of burns treatment, the late thirties of this century saw the fact that a patient with a 30 percent total body surface area burn had to meet his death. In the early fourties, however. some experts in traumatic surgery. after applying ski n grafting (a technique in the Surg ical operation) in the treatment of burns. discovered that keeping a burn wound dry for scabbing helped excision of the injured tissue and the subsequent skin grafting. They thus put forth the Dry Burn Medical Science. With the Coordination of the systematic treatment. a patient with large burns was saved. It was at the time a breakthrough. Along with this advance developed two medical schools in the world Burn: Dry Treatment and Surgical Operation. both of which adcated keeping a burn wound dry for scabbing and excising scabs for skin grafting while treating a deep second--degree burn and beyond. But it so happened that the doctors felt much guilty when they saw a saved patient. for the patient. saved but disfigured. was a disabled body only. Faced with the disturbing reality. the experts in burn pathology and histology started researches in their fields and found the dry therapy would lead to necrosis of the living tissue. They therefore appealed to the world to stop dehydration in treating burns. However. their appealing had met with no desired support because they were unable to provide a new effective measure. In recent years researches in trying to find out a new therapy have been conducted in many contries but all have fallen short of success. This has made possible for the dry therapy to remain the only clinical method until the present time. Right at the time doctors all over the world were trying to find a new approach. MBMS emerged imbued with Chinese characteristics. its appearance has ushered in a new sphere in the burn medical science and framed a new medical system of handling large burns. It is highly valusd for its capabilities of reducing pain, of checking infection, of stopping the progessive necrosis of the burn tissue and of healing a deep wound without scarring, which are the four great local cure headaches haunting the world burn field.

The main contsnts of MBMS

MBMS owes its lineage both to traditional Chinese medicine and to Western medicine. Basing itself on the philosophic category of "Moist Burn Medication" produced by resorting to Ying and Yang and Five Substances. a philosophy in traditional Chinese medicine and on the observation of the course of burns, it advanced that a burn is both a wound and an ulcer. Under this guidance, a new medicine--the Moist Burn Ointment (MBO) has been produced and a new medical principle established. which casts emphasis on promoting circulation by removing blood stasis. on clearing away heat and toxic materials. on removing putrid tissue and on promoting growth of new tissue. Therefrom resulted an index pendent academic system of Chinese medicine in the treatment of burns. Through reseaches in burn pathology and histology, it indicates that a burn is characterized by an ulcer and a set of concurrent injuries caused by scratching. tearing. squeezing and pressing and baking. It epitomizes a burn in at least ten types of injuries caused by (a) dehydration of the tissular cells. (b) excretions of disintegrated tissular cells, (c) chemical materials engendered after the tissular cells are burned, (d) progressive thrombosis of microcirculation of blood vessels, (e) tissular oedema, (f) invasion of microorganism. (g) accumulation of tissular metabolite, (h) scars left from the abnormal therapy employed in repairing tissue, (i) the elements in the air and (i) malpractice of doctors. Judging by the epitome, it is clear that in treating burns the ten types of injuries must be handled first, othervvise the injured tissue will not be treated. This affords a basis for the setting up of the Moist, Exposed Burn Therapy (MET) equipped with modern science. With their mutual functions MET and MBO embody MBMS whose mechanism includest 1. maintenance of moisture in a burn wound, 2. discharge of necrotic tissue in the form of liquefaction, 3. active free drainage of a wound through medicaments : 4. continuous Supply of fixedly concentrated medicaments to a burn wound, 5. seperation of a burn wound trom the air for avoiding the injures thereof. MBO. a medicament possessing sebaceous and relevant pharmacologic qualities, produces neither to-city nor side--effect in treating burns because all its ingredients are extracted from natural plants. A cure for burns, it is also a sovereign remedy for a surgical trauma. In 1987 the National Scientific Commission ranked it among significant scientific and technological achievements, and it was approved by Public Health Ministry to be a new medicine in 1988.

The academic achievements of MBMS

1. Pain, a great headache in the treatment of burns. has haunted doctors for generations.In China a method was once secured which aimed at killing pain with a kind of ointment but it was not carried forvvard because of its failure in draining patrid tissue. Doctors in Western medical science have tried topical narcotics and thalamus inhibitors but have seen no progress as yet, the former disused because it inhibits the activity of cell resperatory enzyme. the latter losing its popularity by reason that it affects the nerve centre. unfavourable for the management of extensive burns. The conventional medical science has tried but failed to produce any effective measure. For example. the dry therapy aggravates pain. antibiotic drugs easily cause pain,an operation is completely Out of the question in alleviating pain, the skill of protecting a wound by dressing. although somewhat effective in removing pain at first will later occasion pain, when the rejection of the wound occurs. Pain has therefore become the international hardnut to crack. Yet ever since MET was put into practice. the situation has become quite otherwise, Starting with the research in the protection of a wound by seperating it from the air and by avoiding medicaments which are able to relax the smooth muscles of hair follicle and to drain freely and timely metablites of a wound, removes pain completelV within a few minutes or sometimes even within a few seconds. hence making an end of the pain lording history in the handling of burns.

2. It is widely known that infection of burn has been a horror both to doctors and to patients. The dehydration applied in the treatment of burns is motivated for preventing infection but. according to modern science, it does not tally with the medical law and can not control infection. Many antibiotics have been produced for the same purpose but none has been satisfactory, so up to the present time infection remains a threat. Expounding a burned wound with great editional Chinese medical science, MBMS has made use of pathophysiology histology and microbiology to analyze carefully an affected wound and then created the foflowing medical principle : To control infection thoroughly, it is a must to enhance the local tissular immunity. to create an environment able to hinder the excessive bacterial breeding caused by the imbalance of bacterial. groups and to enable the medicaments on a wound to move in natural cycles so as to drive oUt putrid tissue. In the general hospital of Kunming military region. the doctors led by Fangdonhai have performed an experiment in pathology and isotopic . sign of the burn wounds'treated both by MET and Dry Scabbing Therapy. they confirmed that the bacteria in the burn tissue treated with MET are rather confined and unable to cause infection : whereas those with DST proliferate and easily cause infection. Their experiment furnished faithful materials to boost the theories of MEMS in combating infection. In Tong-clan Hospital Beijing. People's Hospital Mudanjiang, the first hospital attached to Hunan Medical University. Nanyang clinical burn centre 'Henan and in many other hospitals across the country, the two treatment groups were closely compaired. The comparison showed that in the moist group in fection did not occur at all and that MET was 100 per cent effective in controlling the infection of a wound previously caused by another therapy.

3. After burning, a wound is seen to progressively necrose, which will make the wound deepened. Such a progressive necrosis. in the viewpoint of the conventional dry medical science. is doomed to take place. As a result, to prevent the tissue being affected in the course of progressive necrosis. the doctors have done what they could to accelerate the necrosis by desiccating the tissue to form a scab. In the middle sixties. however. it was discovered that the tissue was not predestined to necrose and might be saved if proper measures and efforts were involved. But so far all preventive .measures available are. on the whole, unsatisfactory. To stop the tissue from necrosing,of particular importance is the understanding of etiology of such a necrosis. After the careful examinations of some wounds. three causes have been confirmed, they are; (a) the dehydration of the wound: (b)the air which has invaded the wound unnoticed- over a long period of time, (c) the microcirculation of Cutaneous stasis belt developing the progressive thrombosis which pauses the stasis zone and injures the living. blood--supplying tissue. Focusing on the cure of these injuries. MBMS with MET and MBO being its weapons. has Succeeded in hindering the wound from necrosing progressively. This has been verified by the clinical data from the burn centres and hospitalsacross the country. In the burn section of the First People's Hospital' Mudanjiang, MET and Dry Exposed Therapy were compaired in treating the same degree burns. The dry therapy demonstrated the bUrn wound deepened, the superficial second--degree burn changing to a deep second--degree burn. Thewound treated with the moist therapy was reported to go the other way around. They were also recorded to be different in the time of healing. The moist therapy healed a wound 7--8 days earlier than the dry therapy.

4. A scar is the main cause leading to disability. For years. many doctors have conducted big quantities of experiments in order to reduce the scarring rate, but theV have found no way out. consequently they concluded that a deep second--degree burh can never heal but that it leaves a scar. Their theory is : After burning the epithelia of the residual cutaneous appendices regenerate and extend along the leucocyte moist belt under the crust until they close the wound.But, around 20 days after closure, the tissue of the skinned wound will unavoidably develop hyperplastic blood vessels and cellulose, which will eventually lead to hyperplastic scars. Such a theory has prevailed for a long time. As a result of it. a good many patients now wear on their days with serious cosmetic and functional disablement, of whom a number are children who are too innocent to know what their lives will be. The families and relatives will thus long be implicated. The doctors. dealing for years with the treatment of burns, hold that it is unavoidable for a deep second--degree burn to leave scars. With a view to reducing moral suferings of patients, they comforted them by saying "You are born with such constitution, therefore dootried to be scarred when exposed to buyning." So over a long period of time, when they conducted the researches, they relied for the reduction of scars only on the surgical operation without resorting to repair of the injured tissue. But unfortunately a surgical operation is unable to remove scars effectively. MBMS. free from the conventional view, started with a study of repair of the in in red tissue and discovered that the epithelia of the residual cutaneous appendices are generated when they penetrate into the dermal tissue from the hasal epidermal stratum at the period of embryo. They possesS the qualities of the cells of the hasal epidermal stratum and therefore are able to reproduce and to turn into the hasal cell stratum of epidermis. An observation of cutaneous circulation has shown that the blood vesse rete of dermis is assured to regenerate the blood vessel rete of the dermal papillary layer. It has also been observed that the ratio of the fibrotissue of dermis to the residual epithelian cells, starts on postburn day 4 to increase from 4 to 1 to 20 to 1. After the application of MET and MBO, the excessive reproduction of cellulose was controlled and 'the epithelial cells promoted to reproduce and to be divided. These factors have long been ignored by the conventional therapist who have focused only on scabbing. When a burn wound is crusted, the epithelial cells will not be reproduced to turn into the hasal epidermal stratum and the blood capillary of dermis not be set up. The glands will not recuperate and the cellulose be unchecked but rather reproduce excessively on account of bad blood supply. Therefore, when the epithelial cells heal. on cutaneous concavity. a newly recovered "skn", acted on by the cutaneous reproduction and self inthibition, will have disorder and hyperaemia of blood vessel rete and hyperplastic fibrotissue. After that. some of the residual epithelial appendices will develope cyst and fibrosis because of drainage difficulty, which will eventually lead to the hyperplastic scar. MBMS. running counter to the dry therapy in the tissue reparation, has adopted a medical principle which is to tet the skin take its own course. thus making it possible for a deep second--degree burn wound to heal without scarring. That a deep degree burn wound heals without scarring has been confirmed by the clinical data presented at the First National Meeting of the Moist Burn Medical Science. And it was also confirmed that the scars previously caused by another therapy will be removed or softened if MBO is timely applied.

5. For a third degree burn, few researches have been carried out in its treatment. for it is a full thickness injury. different from a deep seconddegree burn. and Used to be treated by no other therapy than a surgical excision. Not until MBMS was established was there some progress in this field. The moist medical therapy, after being tried on a third--degree burn for shedding crusts, has revealed that a superficial third--degree wound burned to the adipose stratum still cures. Some histologists hold after appraisal that So percent sweat glands are in subcutaneous fat and that, by culturing auto--sweat glands epithelia, a wound will be closed by the epithelia with no skin grafting involved. its healing proceeds as follows; After burning the deadtissue begins to dissolve, followed by rejection and seperation. The moist therapy, applied at this time, will drive the dead tissue out of the wound and enable the residual adipose tissue to regenerate fibrotissue and to restore blood circulation. Stimulated, the sweat glands'epithelia in the adipose tissue will be reproduced and divided into nonexcretive epithelial cells. In the end the epithelial cells will cover the granulation tissue until they heal the wound. With regard to a deep third--degree burn, the moist therapy has been tried in treating the burn of small area and worked an effective cure. Such a burn relies for its healing on the epithelia of the wound edges which extend to cover the wound. In treating a deep third--degree burn of large area, however. support is to be drawn from skin grafting. MET serves by discharging the:necrotic tissue in the form of liquefaction and thereby retains as much subcutaneous tissue as possible to conveniece the subsequent skin grafting. The jiquidized discharge, taking place of a scalper in removing the necrotic layer. protects the subcutaneous tissue which would otherwise be injured accidently by a scalper. Treated with Such a joint treatment, the tissue of the healed wound is much better developed. Such a treatment has clearcut Superiority over the therapy which does nothing but excise eschars. In order to speed the Iiquefaction of a third--degree wound. the doctors in Nanyang clinical centre have employed scalpers to inflict many cuts on the necrotic layer. which assisted the entry of the ointment and bettered the efficacy.

6. An extensive burn is different from a local burn not only because it emtbarrasses the handling of the wound but also it brings about many more changes in a burn patient. In treating such a burn. different treatments will work diffent systemic changes in a body. For this rcason what has been achieved by the conventipnal dry therapy in treating extensive burns is not to be shared by MBMS. Treated with the dry therapy. a patient with 60 percent burns. will each day lose at least 2 to 3 litres of body fluids, 60 to 90 grams of protein and 2 thousand great calories. In order to make up for the losses. the patient must be infused with fluids or aided by other supportive means to counter shock and to check infection. However. a patient, if treated with MET. will need neither infusion of the above lost fluids nor support of protein nor caloricity. for the moisture maintained in a wound Prevents the losses. These two methods should not get mixed up in treating a curn patient, otherwise the patient's life will be threatened. A doctor who uses MET must discard all conventional methods and, basing himself again on the basic surgical principle. sum up the experience of MET in treating large burns. Promoted nationwide for no more than half a year.MET has demonstrated its ability in surmounting the technical difficulty of treating large burns. in Nanyang clinical centre, a patient with 94 per cent body surface area burned (40 per cent of the deep second degree burn and 50 percent of the superficial third degree burn) has been Cured without causing disablement. This is the first achievement'of its kind ever made. Up to now no other therapy or technique avaeilable in the world can be compaired advantageously with MET which indeed serves not noly to save the patient but to cure the sickness.

All the ctinical materials presented at the First National Meeting of Moist Burn Medical Science have shown that it is not difficult to cure burns involving 30 to 50 per cent body surface area. If a burn is not simultaneously attacked by many other diseases or by a respiratory injury and treated strictly with MET, 100 per cent effectiveness will be secured. And in some basiclevel hospitals in which MET is employed, the burns involving 50 to 94 per cent BSA have been cured, Although a factory's hospital owning no bacteria--free ward snd whose medical facilities are not better than in a country's hospital, Nanyang burn centre has received 35 patients whose burn areas ranged from 64 to 95 TBSA (one with 90 per cent TBSA), of whom 32 Were Cured without causing dissblement. MET has been proved to be far more gdvanced than any conventional therapy employed even in a best hospital abroad. It would be more encouraging if we compae their efficacies by the disability rate. No patient treated with MET has been discharged with disablement from Nanyang burn centre or from other hospitals whereas, looking into the data of a most advanced hospital it is discovered that almost all the Patients treated with the conventional therapy have had different degrees of disablement, few of them have been able to get back to their work. It is doutless that if Nanyang burn centre owned the same highquality medical facilities, it won id perfect its treatment and raise the cure rate. Using MET. Xinhua hospital Taiyuan, a small factory's hospital has cured a deep burn wound involving 80 per cent TBSA. and it is even more amazing that sole village hospitals have employed MET to successfully treat the patients with 50 per cent burns. To tide a patient over the shock stage, MET requires }only two thirds or one half of the total amount of fluids needed by the conventional therapy to infuse into a burn patient and only some commonly used antibiotics are employed to check general infection instead of high quality ones. It is also much simpler than the conventional therapy in nourishment support and in maintaining the balance of water and electrolyte.

7. In retrospecting the history of burns. the conventional dry therapy is found to have been powerless not only in treating the devitalized tissue but also in curing a chemical burn. However, MET and MBO have worked a remarkable cure for a chemical burn. To treat a chemical burn. it is necessary to repair the devitalized tissue and to handle the influences that cause the burn. Managing with these two factors. MBO was produced with the ability to act on acid and alkaline by "neutralization". By self-consumption it will "neutralize" the chemical materials in the wound and timely discharge the dead tissue by "auto--mobile function". eventually effecting a cure. In Tong-clan hospital Beijinq. the two patients with large burns caused by phenol were successfully cured with MET. which has broken the record of the treatment of the chemical burn in the world. The doctors in a steelwork's hospital in Xinyu, Jiangxi. have made a breakthrough theoretically in treating a cement burn. They believed that MET is able to destroy the "insulation layer" of a burn wound and to alleviate the injuries caused by cement to thg skin.

8. In the treatment of an electric burn, a great breakthrough has been made : A three dimentional burn. an electric burn is paticular with its own characteristics in addition to being a burn like other types of burns. When an electric burn occurs. it will produce much of half living tissue and cause progressive thrombosis which will affect arteries and veins. The tissue passed by the electric current will be devitalized and simultaneously, because of the penetration of electricity, the unwounded muscles with their nerves stricken suddenly by electricity will develope continuous convulsions. These occurances complicate the wound and thereby inconveniece the management. In the past for fear that a patient should die, the early amputation was proposed. At the time it was believed that if the early amputation was not performed, the deep tissue was to suppurate which would trigger general infection and the muscles be necrosed causing poisoning. MET and MBO. used as what they have done in treating other types of burns. have been used to treat such a .burn successfully. The ointment smeared on an electric burn will penetrate into the wound, liquify the dead tissue and discharge them timely. The discharge of the necrotic tissue prevents the living tissue festering or being poisoned, and therefore conserves as much tissue as possible and protects limbs. On the other hand. as the ointment is possesse.d of the power of relaxing the smooth muscles, it is able to stop convulsions and to help to restore the local blood circulation.

While treating burns, some doctors have also employed MET to cure cutaneous traumata, ulcers and bedsores. Kunming General Hospital of Chengdu military region has scored a great Success in treating obstinate ulcers and bedsores. Because a burn is both a wound and an ulcer, MET. besides its ability to treat burns. is also much effective in treating a wound--ulcer.

The Medicine of Burns and Ulcers,

A General introduction(1)

(Abstract)

Xu Rongxiang

Director of Beijing Guangming Institote of TCM Burn, Wound and Ulcer

This paper deals with the definition. historical background and philosophical theory of the medicj ne of burn and ulcer.

The Medicine of Burns and ulcers. being a new system of traumatic and trauma plastic medicine, is established on the Chinese traditional theory, principle, methodology and pharmaceutics with the law of differen.tiation of syndromes and composed of four branches. viz.,burn, open trauma. superficial ulcers and orthopedics. The therapeutic basis lies in the treatment of the intrinsic lesion of disease with natural mode. method and materia medica and its general idea is that all Superficial ruptured ulcer fall under the category of medicine of burn and ulcer.

The philosophical system composes of a differential diagnostic system of syndrome either overall or individually or. in other words, the development of an overall macroscopic idea towards a rather concrete direction, resulting in a corresponding concrete conclusion so that an entirety of differention diagnosis of syndrome is thus completed. Next, the concrete conclusion is decomposed into several individuals, the developmental law of which and their relationship are thus studied. and the concentration laws of all individuals are summarized. Then it is further developed toward the entirety direction to complete the differentiation of individuality. The basis of this differentiation system on which the transformation of burn medicine is primarily completed, and a breakthrough in its development is thus achieved.

This paper gives a detailed description of the formation of basic theory and clinical aspect of the Moist Exposed Burn Therapy for burn. puts forward the five conditions for ideal treatment of the wound, viz., to keep the wound moist but not soaked to expel the necrotic layer through liquefied mode from superficies toward the underlying tissue at the peak of its reaction. timefy and free drainage of discharge in the wound with the aid of drugs. continuous supply of fresh remedy at concentration under the action of drug. to isolate the wound with liquid cream and oil layer so that the dicharge might be expelled in time and thus the won nd can be protected from in in ry by air and filthy materials without being soaked. The paper gives more space to the description of the mechanism of this therapy which. having been verified through clinical practice, offers a solution to the different problems in the treatment of burns. long annoying the workers in the field of burn, including pain in the wound. the management of necrotic tissues.subcrustal infection, restricted drainage. deep II scar formation. progressing necrosis of the remained tissues, drV damage. Since this therapy is designed on the principle of not to be restricted by the medical conditions. this method is simple and readily accessible and economical as well.

Report on the Moist Exposed Burn Therapy

in Treating 2076 Patients

(Abstract)

By our staff members Zhang Liu-clang Yang Refei

Based on the sampling investigation of 15 clinical units. this paper makes a statistical analysis of the treatment of 2076 burn patients with the Moist Exposed Burn Therapy. Attached is also a brief introduction in discussion to some other hospitals. which Succeeded in treating other types of body surface impairments with the therapy. The general cure rate, in treating this group of patients, is 99.42 per cent. Given the limit of 40 per cent boby surface area burned, no patient involving less than 40 per cent BSA died. the patients with . BSA involved larger amounted to 11 7. the most serious of all involving 97 per cent BSA. 12 of them died, the cure rate being 89.75 per cent. The calculation of discharging time of each patient. suffering different degrees of burns, is based on the healing time of the deepest degree : The cure of a Superficial second degree burn takes 10.76 days, a deep second degree burn 20.10 days. a third degree burn 33.69 days.

Causes of death : 2 patients died of the direct Suffocation caused by the injury of the resporatory tract. 5 patients of systemic infectious septicaemia. 2 patients of early shock (Both died within 3 days). 1 patient, suffering the massive bleeding of stress ulcer, died of the uncontrolled bleeding, despite that he had been subject to the subtotal section of the stamoch. 1 patient could not be saved because of the poisoning bacillary dysentery. 1 patient died of the electric burn compicated by the bone fractures and cerebral injury.

The following are the generally acknowledged advantages of MEBT:

1. MEBT keeps a burn moist yet not macerated. and thus prevt3nts the wound further injured by desiccation and the air. The ointment smeared on the wound creates a moist environment,faVQUrable for the healing of the wound.

2. It can drain the excretions timely out of the burn tissue. by the manner of active drainage. The ointment is able to fend off the exeretions from the wound, and in this way enables the wound to avoid and to check the infection. which would otrferwise have been caused by the obstructed drainage.

3. It discharges, from surface to depth. the necrotic tissue. in the form of liquefaction. at the time when the rejection of the wound occurs. Such functional principle tallys with the requirements of of imcal practices. The liquefaction. being reliable clinically. prevents the living tissue from baing infected and absorbing poison. Critical to its Success, however, is the timely removal of the liquefied materials.

4. The clinical observations go to prove that MEBT functions much more effectively than the Dry Exposed Therapy in restoring the the microcirculation of the stasis of a deep second degree burn.

5. The pain cuased by burns is the greatest of all illnesses' sufferings. MEBT and MBO have, in clinical practices. solyed this problem. Generally the ointment. after being smeared on a Wound. will kill the pain within one or ten minutes, and make sure that there will be no pain at all in the coures of the treatment.

6. Many hospitals have made comparisons between MEBT and the Dry Exposed Burn Therapy, and have found sharp differences between them. in the healing of the wound. MEBT prevenst and checks the infection of the wound.and is also able to better the microcirculation of stasis and to create a favourable environment for the reparation of the wound. Its unique functions promote the healing of the wound. reducing the excessive hyperplasia of collagenous fibre, and thus enable a deep second degree burn to heal without scarring. A third degree burn of small area treated with MEBT. too, can be healed.

7. While using MEBT to treat burns, big doses of antibiptics are not generally required to apply to the whole body of the patient, the patient with small burn area needs not the assistance of antibiotics. A child victim, with large burn area, can be applied broad--spectrum antibiotics at the early stage. In general antibiotics are to be used about 15 days after burning. The doctors hold that the abilities of MEBT to drain the Wound, to better local blood circulation, and to effectively seperate the wound from the air. make it possible tor the wound to avoid infection. The use of MEBT allows an obvious reduction in the application of antibiotics. The clinical statistics go to prove that the infection rate of the wound treated with MEBT, is less than 1 per cent, and that it controls the infection of the wound, at the rate of almost 100 per cent.

8. The therapy. being handy and easily handled, sets no stress on the bacteria free environment. It can be employed by hospitals at different levels, and is suitable for those who work outdoors and for family use and emergency treatment. And also it is effective in treating exposed wounds and body surface ulcers.

Brief Summary

The statistical data of this group are selected, by the manner of sampling, from the hospitals of different levels, and are presented by the doctors, who, for 7 days, have been trained in MEBT, and who have scored a success in clinical practices. And yet, it can be seen, judged by these data, that the doctors have not well mastered the medical law of MEBT. In treating the patients of large burns, they are still less skillful. Their prelimenary clinical practices, however, have gained unprecedent effects and laid the practical base for the development of the medical scIence.

Experience on the Treatment of Extensive

Burn with the Moist Therapy

(Abstract)

Li Weudong Pang Yudian Zhao Junxiang

Nanyang Mealyal Center for Burn and Sore, Hospital if Second Machinery Factory, Ministry of Petroleum

35 cases of extremely severe burn were treated with a total cured rate of 91% Only 3 cases died. The area of burn ranged from 60--96 % with 45--81 % of area deeply burnt. 30 cases revealed shock of various degrees when admitted, 35 cases were complicated with insufficient visceral fanctions, 5 cases with respiratory infection.

Therapeutic method .

1. Early and local treatment. Keep the respiratory passage well ventilated. Oxygen inhalation and sedatives were given. Transfusion route was established. TAT and simple debridement were also performed and the Moist Burn Ointment given. Many # shape incisions, 1--2mm deep. were made with lancet in order to facilitate the infiltration on drugs applled.

2. Good management for treating and preventing shock and visceral complictions. The volume of transfusion was maintained at the level so that the patient's urine excreted at the speed of 50ml / hour, pH kept at 7--7.5 and pulse rate not exceeding 120 / min. Oral aluminum hydroxide gel cimetidine in small dose were also given. Restoration of intestinal peristalsis and early nasaf feeding with high nutritious food were needed.

3. Anti--infections Regular antibiotics and metronidazole were administered. High vitamin C was given. Repeated whole blood and plasma were, given too. Low blood zinc should be checked in case needed.

Results; All physiological functions restored except few scar formation in some extensive ill degree burn. No disability happened. All the 3 fatal cases were admitted too late with no anti--shock treatment for their severe shock condition before admission and died of multi-- functional failure of the viscera.

Clinical Application and Experimental Study of the Moist Exposed Burn Therapy

(Abstract)

Fang Dongkai Zhu Can Luo Xuelin Li Hualing Dai Tingen Guo Yuanfa

Kunming General Hospital, Chengdu Military Area, PLA.

Among the 85 cases of burn, 78 were burned during normal daily time. while 7 in war time. 2 cases revealed traumatic ulcer, 1 case had sacral-coccyxic bed sore. 44 cases had an area of less than 10% 11 burn. 23 cases, 11-30% or 10% ill burn: 10 cases had 31--50% or 10-20% m burn, 8 cases had an area over 50% or 20% Ill burn. Results showed 85 cases cured. The average time of hospitalization was 36 days, with 3 fatal cases. To elucidate the machanism of clinical therapy. pathological studies in animal with 11 burn were made with radio--isotopes. Results revealed that, in the group received no remedies, under the microscope, the granulation tissue appeared withered, with infiltration of lobulated white cells in the epidermis, eosinophilic collagenous fibers. and lifeless tissues (fig.5). While in the Moist Burn Ointment group, under the microscope. the fibrous cells proliferated actively with rich vessels and granulation full of vitality (fig.6.7). The above clinical and experimental results showed that, clinically. the Mosit Exposed Burn Therapy is capable of stopping pain and decreasing damage in the wound. promoting healing of wound. preventing infection. with no scar formation after healing in 11 burn. And this is, therefore. an ideal therapy for burns of various degrees in hospital at different levels.

Clinical Analysis of the Moist Exposed Burn Therapy in Burn, A Report of 50 Cases fherapy in Burn, A Report of 50 Cases

(Abstract)

Zhao Rubying Tian Lixue Zhao Guoying

Tongxian Couty Hospital, Beijing

During the last Vear or so, we have treated 182 cases of burn, a common disease with no satisfactory therapy So far. though various measures have been suggeS.ted. As compared with the old dry bandaging method. the effect is quits stisfactory. StatiS.tical comparison was made between 2 groups. each 50 cases, randomly selected, treated with moist--exposure and dry bandaging methods respectively. The results were, for rate of wound infection, P<0.001 : rate of skin grafting. P<0.001, applications of analgesics. P <0.001, anesthetics applied in debridement and dressing change. P<0.001 f rate of healing of scar tissue, P<0.001, rate of transfusion. P<0.001.

Application of the Moist Burn Ointment in Burn

(Abstract)

Xing Jun Zhang Zheng Guo Wei

Center of Research and Trestment for

Burn and ulcer, Binzhou Medical College

This paper mainly deals with the method points for attention. and.the improvement of general therapy. It was observed that, in burn of ill o, there were formation of skin islet and the growth and extension of skin grafting. In a period of 3 months. 245 cases were treated, among them, 64 were admitted add 181 treated at the OPD. All the 61 cases with a burn arga< 50% were cured. while 3 cases with an extensive burn area over 90% were transferred from hospital upon failure of the condition. with 2 cases died and the other case was discharged by interrupting the treatment. It has been proved, through clinical practice, that the application of the Moist Burn Ointment in the Moist Exposed Burn Therapy was satisfactory for treating pain. infection. scar formation in deep II burn. In extensive burn of III. the Ointment promotes the formation of epidermal islets in the sweat gland of adipose tissue and its proliferation. After skin grafting. with the flap in the wound. it promotes and accelerates the growth and expansion of graft. being 0.1 --0.3mm quicker than the traditional therapeutic method. The distance of graft expansion was over 5mm.

332 Cases of Bum Treated with the Moist Burn Ointment

(Abstract)

Sea Guangxin

Medical Center for Burn and ulcer,

Xuan Wu Hospital of TCM, Beijing

During the period of July. 1987--January. 1989, we treated 332 cases of burn with the Moist Burn Ointment alone for Moist Exposed Burn Therapy. All the cases were cured. Among the 332 cases. 125 were male, 127 female, 66 case.S were children, the age range was 10 months to 80 years. 14 cases were with scar ulcers. For area of wound. 288 cases had an area less than 10% 26 cases, 10--20% 18cases. 30--60% For degree of burn, superficial II degree, 1 98 cases. deep II degree. 110 cases, III degree. 24 cases. Results revealed total cured with the Moist Burn Ointment, with no scar formation and functional disturbance either. There was no wound infection. sceptieemia. skin grafting or fatal case. 4 cases of children manifested scarlet fever on the second day of admission. and were cured after antibiotic. administration. The average hospitafized duration was 25 days. This paper gives a detailed description on the manifestations of wound during the therapeutic course, and the principles of wound management. The application of the Moist Exposed Burn Therapy and the Moist Burn Ointment possesses the following merits; stopping pain, countering infection. decreasing stagnant tissue and its progressive necrosis, decreasing injury and scar formation. There was no scar formation in II degree burn. The therapy features simplicity and convenience.

Analytsis on the Emcacy of Dry and Moist Methods in Burn Therapy

(Abstract)

Du Fuqin

Hospital of Depatheant of Vessel and Bridge for

War Preparednes, Ministry of Railway

Comparison was made between therapies of dry exposure (DE) and moist exposure (ME) methods. Of the 121 cases, 50 were in the DE group with the largest burn area of 60%, 71 were in the ME group with largest burn area of 58% Most of the cases were superficial and deep II degrees, some with small area of III degree. In the DE group the spontaneous healing rate of wound was 96% rate of infection of wound was 98% rate of antibiotic administration 1.00% rate of skin grafting 4.00% rate of scar formation 22.00% While for the M E group, the rate of spontaneous healing of wound was 100.00% rate of infection of woked 2.81% rate of antibiotic administration 2.81% rate of scar formation 2.81% Analysis, was made on the issues of application of antibiotics. wound infection. and scar formation.

Report on the Treatment of Burn in Personnels from Nansha Naval Vessels

(Abstract)

Hu DongCai Li Decai

Research Center of Marine First Aid,

No. 422 Naval Hospital

Due to the special conditions of naval troops. such as concentration of personnels, explosives and inflammables, there is a high incidence of burn injury with increasing tendency. For instance, during the-sea war in Xisha area. the incidence of burn reached as high as 14.8% MoreoVer. logistics support is difficult due to long distance from the continent. the patient: cannot be sent back to the hospital at the base. once a burn occurs, the patient can only be treated on board. Hence, early and effective simple measures are vital to burns in naval personnel. Very satisfactory results were obtained in 84 cases of burn treated by the Moist Exposed Burn Therapy. During the period of Nansha war,16 cases of Superficial and deep n burn were treated on board. The effects were lst stage healing in the wound, with normal elasticity of the skin .no scar formation. The functions of the joint were normal. This greatly increased the fighting capacity and decreased the occurrence of disability.

Experience on the Treatment of Residual Wound

Surface by the Moist Burn Ointment

(Abstract)

Chen Yushi Mao Zhisheng Wang Jing No.97 Hospital, PLA

Zkou Hannn Liu Shi'an Hospital of 83569 Troop, PLA

During the last phase of burn, remained wound used to occur and may last for a long time, sometimes with general complications difficult to tackle. During the period from January--October. 1988.21 cases of late stage of burn with remained wound, crust ulcers and chronic ulcers wound were treated with the Moist Exposed Burn Therapy with satisfactory results.

The area of remained wound was 2-3% in average. with the greatest area of 6% The mean time of healing was 19.4 days.

Method of wound treatment: 1. Moisten the wound and then apply the Moist Burn Ointment 3--4 times a day. 2.Those granulation with severe edema should be compressed with hypertonic saline for 2--3 days and then covered with the Moist Burn Ointment, 3. For crust ulcer. the ointment is applied after debridement and then covered with a layer of paraffin gauze and bandaged, changed twice daily. 4. For chronic ulcers, the wound should be debrided and applied exposure or semi--exposure methods. Apply. the paste 3--4 times daily. For severe hypertrophic scar tissue at the joint. when the fissure in the ulcer is rather deep, apply the drug at the superficial portion and then covered with moderatly thick isolated skin flap.

Effect of the Moist Burn Ointment in 1 Case of Extensive Burn

(Abstract)

Chen Shied Wang Yang Zhang Xuezhong Guo Dong

General Hospital of Benxi Steel Plant

A case of severe burn with total area of 92% in which 80% was III. The patient went through the period of shock in stable condition. Most of the ill area were treated by crust excision. particle grafting and partial amputation. The wounds at the back were protected with SD--Ag. 36 days after burning. part of the won nd were applied with the Moist Burn Ointment. the remaining parts were protected with amniotic membrane treated with silver nitrate. The wound treated with the Ointment healed in 2 weekswith smooth skin of even thickness. Similarly, the membrane covered parts were also healed, yet. the skin was thinner than the former. When 1 x 0.4cm2 of skin were obtained from both parts separately and examined under the microscope. the ointment treated skin . were seen with a cover layer of squamous epithelium with cells well arranged in each layers Newly growth epidermis can be seen with occassional sweat glands seen in the dermis. For the membrane treated parts, squamous epidermis were also seen with edema at the superficial layer of dermis. The collagen fibres were ruptured. No skin appendage structures were observed. Moreover, part of the wound with crust was seen that, under the crust. the wound was of III lesion with granulation. After applying point skin grafting for superseding debridement, the wound healed completely. It can be seen that the results were sig n ificantly different.

Treatment of Neonatal Burn by Phenol

(Abstract)

Luo Lide

No.4 Municipal Hospital Zigong, Sichuan

A neonate just delivered for 10 minutes was accidentally burnt by a midwife with phenol with an burnt area of 6% 30 minutes later. the newborn manifested polypnea with 68--72 breaths / minutes, fine raies in both lungs. the heart rate being 174-186 / min. cold limbs. weak heart sound. and cyanosis. These were manifestations of compensatory stage of respiration and circulation. In the afternoon. breathing slowed down. muscle tone decreased. The patient was in a critical condition. RBC 5.24x1012/ L. Hb 1669/ L. WBC 20x109/ L. Urine protein (+). granular cast (+), phenol (+). Diagnosis, neonatal burn by phenol. with secondary functional failure of multiple viscera.

Treatments wet compress with saturated sodium sulfate followed by the Moist Exposed Burn Therapy. The patient was kept in an incubator and calm down 10 minutes after treatment. Two weeks later. the necrotic tissue became liquefied with little secretion. The wounds healed without scar formation. The patient was given oxygen inhalation and anti--shock therapy, transfusion and albumin. After 34 hours, the vital signs became stable. The case was further treated for another 18 days with wounds and lung and kidney functions restored and cured. The newborn was discharged. 3 months later, the newborn was found to be healthy. with disappearance of pigmentation and no scar formation and administered with oral "moisten extract", once every six hours for 4 successive days, which might have antidotal and protective actions.

The Influence of Liquefied Materials from Bum

Wounds on Body Temperature and White Cells

(Abstract)

Li Fengchun

Depatheent of Surgery No. 322 Hospital, PLA

Study was made on the Moist Exposed Burn Therapy. The cases were divided into two groups. In one group, the liquefied materials was cleared in time while the other group was untimely cleared. The influence on liquefied materials. body temperature. white blood cells were studied. It was summarized that timely clearance of liquefied materials in the wound at its liquefied stage was the key point of Moist Exposed Burn Therapy in burn, which revealed a body temperature of 38.7 +0.36t and white blood cell 1824. 25 x 106+0.29 /L. While in the untimely late clearance group both figures were 37.22+0.27Cand 1327.32 x 106+0.31 /L respectively. The difference for body temperature was P<0.05, for ABC was P<0.001.

Experimental Study on the Actions of the

Moist Burn Ointment on Promoting Healing of

Skin Wound and Anti--infection

(Abstract)

Xing Dongming

Hospital of Zaozhuang Mining Bureau

3 aseptic incisions. with same diameter and same depth. were made in the skin of rabbit and applied with drug, single ground substance and blank control respectively. The former two were applied at definite times. One rabbit was killed on the 4th, sib days respectively and the tissue from the 3 wounds was taken for pathological examination. As the wound healed. the areas of scar were drawn and calcu lated against standard chart. Meantime. in vitro bacteriostatic examination was made by adopting agar culture and plate drilling method. It was observed that the red.ction in the wounds of the moist exposed group was earlier than the other two groups (P<0.05), manifesting heal promoting action on wounds. Histologically. it revealed that the Moist Burn Ointment stimulates the regeneration of blood vessel in the granulation tissue and its blood circulation, thus promotes abundant oxygen and nutrient Supply and metabolism process. Clinically, it reveals satisfactory anti--infection action. having been verified by our experiment. Strangely. in vitro experiment showed that it has no bacteriostatic action on staphylococcus aureus. escherichia coli. pseudomonas aeruginosa. It was thus suggested that its clinical effect of anti--infection might be realized through the actions of formation of free local drainage and the strengthening of immune mechanism. In the paste group, less collagenous fibers were found in the granufation tissue. this suggests that the paste possesses the actions of inhibiting collagen growth. coordinating the ratio of its growth with epithelial cells. thus decreases the formation of scar tissue.

Circatrix in Burn Treated with the Moist Burn Ointment .

(Abstract)

Chen Huixian Medical Center for Burn and Ulcer, Xuan Wu Hospital of TCM Beijing

23 cases of circatrix patients due to various kinds bf burns were treated. the time of scar formation varying from 1 week to & months.

Clinical observation showed that. on the 3rd day, slight change in the scar was observed. with its color turning from dark purple to dark red. On the 7th day. the scar color in over 1/2 cases became shallow, 1/3 of the patients scar became thinner. 2/5 of the patients scar were softened, 1/10 of the patients scar had its ulcer begin to heal. while 1/8 of the patients had their scar tissue liquefied yet still remained with pain and itching. On the 15th day half of the patients scar turned further light in color and further liquefied. About 1/6 of the patients scar began to be liquefied with itching in 1/4 of the patients. Number of patient with pain decreased from 1 /4 to 1/6. One of the cases revealed capillary network in the scar tissue. On the 25th day. further change of scar color continued in 1/4 of the patients. About 1/5 of the patients had the scar tissue further softened. The number of patient with itching decreased from 1/4 to 1/6. while those with pain, from 1/6 to 1/12. About 1/10 of the patient with original limited limb activity improved. while about 1 / 10 had their ulcers healed and about; 1/8 of the patient revealed new blister formation. 2 cases revealed capillary network in the scar. On the 30th day. 2 more cases had their scar tissue begin softening. Among the 23 cases treated. 14 received therapy for less than 30 days with rather marked effect. The effects were satisfsctory after being treated for 7-25 days. One of the cases had a very thin scar on his left upper limb after being treated for 91 days. The scar tissue, markedly decreased. was very close to normal skin with all ulcers healed and more normal skin among the scar which is pink in color, elastic and with evenly distributed hairs. It seems that the longer the treating course. the better the results. The effects are maulfested as : 1. Stopping itching. 2. Killing pain. 3. Promoting microcirculation in the scar. 4. Improving histologic structure of the scar (the ratio of epithelium and collagenous fibers ). 5. Appropriately inhibiting the growth of capillary network in the scar. 6. Promoting the regeneration of skin appendages.

Changes of Renal Effective Plasmal Flow in Rabbit with Early Burn and the Therapeutic Action of Anisodamine

(Abstract)

Zhang Xiangqing Du Geeing Liu Shancai Zhao Cbuurong

NO.91 Hospital PLA

The effective renal plasmal flow in rabbit with burn was detected by 131 l-o--iodo--soduim hippurate tracer method. An eight--hour continuous observation after burn demonstrated a progressive decrease of effective renal plasmal flow after burn. Comparison between therapeutic and non--therapeutic group showed that anisodamine decreases this tendency. Moreover. continuous administration has a better result than single dose administration. It is thus suggested that anisodamine can improve the effective renal plasmal flow after burn.

Experience on 91 Cases of Pink Eyes Treated with the Moist Burn Ointment

(Abstract)

Fan Jinfu

Hospital of the Longyou Pace Factory, Zhejiang

During the 1988 epidemic of pink eye, (epidemic hemorrhagic conjunctivitis), 91 cases were treated satisfactorily with the Moist Burn Ointment. The remedy revealed marked antiphlogistic and removing conjunctival edema actions. prpmoted excretion of discharge and toxins. shortened the course of therapy, thus increased the rate of cure. Comparison with other therapeutic methods was also made. 15 eases, unsatisfarily treated with traditional method. were treated with the Moist Burn Ointment.The symptoms disappeared after 2--3 days. For the 91 cases treated with the pasted 1. all cases interrupted the administration of antibiotic and ail other remegies. 2. all received the ointment treatment. 3. the ointment was applied on a cotton swab and rubbed directly on the conjunctiva, twice daity until edema disappeared and hemorrhage. and congestion ameliorated markedly. no discomfort experienced. 4. The mild stimulation after application would disappeared soon. Under such case, don't rub the eyes with hand.

Radio Ulcer after Operation of Mammary Carcinoma Repaired by Flap from Rector Abdominis, Report of 2 Cases

(Abstract)

Hut Bosheng Wang Damei Feng Laal Yan Alping

Department of Plastic Surgery, The Third Affiliated

Hospital, Beijing Medical Univerersity

It is a common condition that patients of mammary carcinoma suffer from radio--ulcers, after receiving radical operation and radiotherapy, featuring repeated rupture difficult to heal. Some may even last for decades. skin tube treatment is difficult to handle, which does improve blood circulation and nutrition after the tube peduncle is severed. We have adopted an operation with flap from latissimus dorsi aversion of greater omentum pedupcle with isolated skin grafting. This repaired operation can be completed by a single manipulation and the local blood circulation improved. Another 2 cases were. repaired by grafting from rectus abdominis with similar satisfactory result.

Answers to Clinical Questions on the Moist Exposure Therapy

and the Moist Burn Ointment in Burn

Department, China science center for Burn and ulcer

Rich experience has been accumulated since the technique of moist therapy for burn was popularized two years ago. For better grasping of the technique and Summarization of experience, here are answers to some questions raised in the coures of its application.

What are the applications of the Moist Expowed Burn Therapy?

This therapy is designed for the local treatment of wounds in burn. Its 5 points of capacity have been recognized clinically. Since the wounds in burn embody the characters of all other ulcers. the therapy for burn possesses the capacity for treating all other ulcers. Thus, it is feasible to apply the Moist Exposed Burn Therapy for all other kinds of ulcers and open superficial wounds, and naturally for ulcers as an ideal remedy. Besides, it has an action of keeping the wound moistened and isolated. it is also a good measure for the health care of the skin.

What are the clitheai applications of the Moist Burn Ointment?

Being a kind of r.emedy designed on the principle formulated by the Moist Exposed Burn Therapy. this ointment, non--toxic and with no side effect is applied. exclusively in burn and made of food material and natural vegetarian materials. that can be administered topically and orally. Formulated on the principles, methods and medicaments of traditional Chinese medicine, this Moist Burn Ointment can be applied not only in the moist exposure therapy for burn but also in other external or internal diseases. Unlike chemicaf drugs. this Ointment. though not a panacea, is well suited far its indications with satisfactory results to different extent : it can be applied in burn wound as the moist burn therapy, can be prepared as nonadhesive gauze. It can also be applied as dress--changing material and household medicament. It has a promising prospect and can be widely applied as a new remedy for many disorders besides burn.

How to maer the oboeal technique of the Moist Expend Burn Therapy as soon as posoible?

Investigation indicates that 99% of the over 3.000 physicians. after receiving a short--termtraining of 6 days. have mastered this therapy satisfactorily. Some even successfully cured extensive burns. As shown by the experience of skilled physicians the following points are essential to the mastery of the Moist Exposed Burn Therapy.

1. The old academic idea should be thoroughly changed. Before practical application of this technique. the academic idea of the Moist Exposed Burn Therapy and mechanism of the therapy should be well understood. For instance, regarding the idea of disease therapy, it should be noted that the therapeutic measures for a kind of disease is not necessarily onry relied on a single method; It Srhould be kept in mind to choose the best method after therapeutic practice instead of sticking to the old traditional method. New idea is essential here. By the hypothesis of the Moist Exposed Burn Therapy. the liquefaction phase is a necessary process for eliminating necrotic tissue and is .therefore, beneficial to its healing. In case you stick to the theory of traditional idea of dry exposure therapy which is incorrect. you would inevitably fail to grasp the law of liquefaction and is due to fail in its treatment. It is recommended that. before grasping a new technique, one must only retain the kernel of old things as its basis. i. e. the theory of the developmental law of pathogenesis of a disease, and to comprehend this with one's new practical experience so that new idea and method can be developed.

2. Grasping the medical law. After mastering the theory, observe the therapeutic process by selecting a small area of deep II burn and treated strictly on the basis of formulated process of the Moist Exposed Burn Therapy. The treatment must be carried out until the wound heals, notwithstanding whatever unexpected clinical symptoms and signs occur. As soon as you cure a burn patient by yourself, with this new technique. the impression of the new idea that it can be and has been cured by the new technique will be refinforced. So far. only this moist exposure method offers a chance for observing the whole changing process of burn wound. When you review the design theory and mechanism of the Moist Exposed Burn Therapy. your cognition complete the leaping forward process of from perceptual to rational knowledge. Then you can proceed further into the treatment of large area or extensive burn.

3. To reinforce the grasping of this technique. No mather whether you have grasped the theory of the Moist Exposed Burn Therapy or not, you should follow strictly the method of manipulation for this therapy when treating a burn patient. As soon as you solve the problem of pain in burn with this method. you would naturally go further to probe its mechanism and eventually accept its theory. In addition, when encountering a case with sub--scabial infection with serious infection in the granulation tissue, after you fail to cure it with all other measures, you may mechanically try the procedures of the Moist Exposed Burn Therapy which, upon resolving you difficuit problem, might persuade you. At this point. you would certainly not stubbornly hold that liquefaction of the wound,is the result of infection. To take another example. A wound, which has a chronic course with few exudate yet appears lifeless can be treated outright with the Moist Exposed Burn Therapy. By then. you would witness the changing color of the wound with white secretions. It appears to be full of life and readily healed. At this moment, you would naturally acceDt the facts that the moist measure promotes its healing and agrees with the TCM philosophy that "without pus. there will be no regeneration of tissue". You would no longer stick to the old notion that only asepsis and bacteriocide would promote healing.

4. Skillfully grasp the procedure of moist exposure technique. The manipulation should be performed and varied on the basis of different phases of the wound. The paste should be distributed evenly. At the early or exudation stage, only little paste is administered. Be sure that it covers the whole surface of the wound. At the stage of liquefaction . sufficient paste should be used and the liquefied materials be cleaned up in time. During this phase the process of liquefaction proceeds from superficial to the deeper layer. The wound surface becomes depressed and caved in. In case the necrotic tissue does not drop spontaneously, operation may be helpful. For debridement, only the necrotic tissue is to be remo9ved . Beware not to make a thorougy ckeaning until the wound bleeds. Debridement and paste application may be performed at the same time. Hemostatic may be used to stop bleeding . At the stage of repair, the necrotic tissue in the wound has been totally excluded. The base of the wound is now under a rapid process of tissue repair. Repeated paste application in small amount is needed and the secretion and metabolites must be removed in time. As soon as the depression at the wound disappears, this demonstrates that a deep burn has its dermis completely reginerated. At this point, there are very few exudates. The wound should be cleaned up again, including wet compress for 1/2 hour to temove the exudates and medicaments, A new surrounding is now established. Fresh moist exposure therapy should be followed until total epidernidalization and ocmplete healing of the wound is reached.

(Translators: Ying Bo, Cai Jingfeng Proofreader: Xu Rongxiang)

Illustrative Cases

A--1. 7 days after an electric burn.

A--2. 40 days after treatment with MEBT. The wound was filled with the regenerated tissue. 30 days after, the epithelia of the wound edge cqvered the wound to achieve the healing.

B--1. A burn involving 92 per cent body surface a rca.

B-3. } 30 days after treatment with MEBT, the wound was healed. (in

zhanjiang)

C-2.} A scalding burn with 70 per cent TBSA involved.

C-4.} 30 days after the treatment with MEBT, the wound was completely healed without scarring. (in zhanjiang)

D--1. The patient burned with 94 per cent body surface area burned. the third degree being 50 per cent.

D--2. The wound was healed without an obvious scar. 50 days after treatment with MEBT.

Animal Experiments

On the two corresponding sides of the hair--shed back of a guineapig, two burns were produced, both being 2 cm in diameter with most of dermis injured. Adlibtum one was treated with the conventional therapy,f another with MEBT. Along with the course of treatmnet, a pathological observation on the wound was carried out.

An--1. Six days after the treatment with the dry therapy.

An--2. Six days after the treatment with MEBT. The wound tissue was sectioned respectively for a pathological observation.

An--3. The pathological section treated with the dry therapy.

An--4. The pathological section with MEBT. The tWo wounds had no obvious differences in depth. 25 days after the treatment, the wounds were basicallV skinned. The skins having been detached from the wounds. the subcutanoous tissue of them were observed as follows:

An--5. (The left side of the picture)

The subcutaneous tissue of the wound resulted from the dry therapV was so thin that the crusts. not completely shed. could be seen in behind. There was no proliferation of the blood vessef rate.

(The right side of the picture)

The Subcutaneous tissue treated with MEBT was thick with the circufation being excellent.

Thereafter. the above skins were sectioned for a pathological examination.

An--6. The section treated with the dry therapy. There was neither epidermal tissue nor the proliferatior of the blood vessel rete. The healing was of fibrosis. Clinically a scar of the third--degree burn was produced.

An--7. The section by MEBT. The epidermis was reproduced well, close to the normal skin composition. The circulation of the subcutaneous tissue was good. There was no scar left.