Burns Regenerative Medicine and Therapy - part 9 ppsx

Experimental and Clinical Study on Burns Regenerative Medicine and Therapy with MEBT/MEBO 123 and scarring of the wound. While SD-Ag offers a degree of prevention of wound infection, it does so at the expense of wound regeneration and tissue repair because SD-Ag inhibits these healthy recovery processes. In an effort to reduce the negative consequences of SD-Ag on tissue regeneration, a modification of SD-Ag application was developed whereby more frequent applications in an occlusive manner strove to enhance the retention of tissue moisture. However, when SD-Ag cream has been used at an increased frequency to avoid wound desiccation, many disadvantages occur including toxicity, and other side effects of using SD-Ag have been reported. These include: transient leukopenia; sulfonamide hypersensitivity and kernicterus; argyria; local reactions of burning, itching and skin rash; delayed separation of burn eschar and regeneration of epithelial cells resulting in an increase of scar formation; increase of bacterial resistance, etc. The pharmacological mechanism of MEBO to treat burns wounds is completely different from SD-Ag. MEBO can promote the regeneration of survival viable skin tissue and cells, then accelerate wound healing by keeping burns wounds in a three-dimensional physiological moist envi- ronment while simultaneously facilitating the liquefac- tion and discharge of necrotic tissues without causing fur- ther injury to viable tissue. MEBO achieves its infection control by means of enhancing the resistance of local tis- sue to infection in the context of an environment which is no longer conducive to bacterial colonization and prolif- eration. Rather than exercising a direct bactericidal ac- tion, MEBO changes the biological characteristics and decreases the toxicity and invasive activity of bacteria. Therefore, we selected SD-Ag as a control to clarify the irrefutably superior therapeutic effects of MEBO as com- pared to the industry’s standards. Effects of MEBO on Burns Wounds Management According to the results of this trial, MEBO promotes burns wound healing for each depth of wound. Remark- ably, all of the deep partial-thickness burns wounds healed spontaneously after treatment with MEBO, there- by requiring no skin grafting. The rate of scar formation was also markedly reduced compared to that of the con- trol group. Furthermore, in this trial, more than half of the clinically diagnosed full-thickness burns wounds could be healed spontaneously by treating with MEBO throughout the treatment procedure without requiring any skin graft- ing. Treatment with MEBO provided burns wounds an optimum physiological environment for regeneration and repair. Subsequent to application of MEBO, the wound would heal spontaneously without further damage to via- ble tissue. Therefore, the rates of scar formation, deformi- ty and disability were all significantly decreased com- pared to those of the control group. Meanwhile, it was found that in the MEBO treatment group, the incidence rate of wound infection was significantly reduced com- pared to that in the control group, indicating that MEBO is capable of preventing wound infection. Analgesic Effect and Alleviation of Pain of MEBO It was determined in this trial that throughout the treatment and during dressing changes, the analgesic ef- fect and alleviation of pain in the MEBO treatment group was dramatically superior to that of the SD-Ag control group. Unlike SD-Ag which required painful peeling away of crusted and dried dressing from fragile tissue, treat- ment with MEBO neither aggravated the suffering and pain sensation during the treatment and changing of dressing, nor did it fail to offer a satisfactory analgesic effect. The need for an analgesic agent was rare in the MEBO-treated group. Feasibility of MEBO for Treating Extensive Burns Patients In this trial, 75 extensive burns patients with TBSA 1 50% were treated by BRT with MEBT/MEBO which resulted in a 100% success rate whereby all patients were completely healed when discharged from the hospital. No toxicity, side effects and local or systemic allergic reac- tions were found. In contrast, 2 of 31 extensive burns patients in the SD-Ag control group died and 18 of them were discharged with some residual wounds. Meanwhile, almost half of the extensive burns patients in the SD-Ag control group who were failing treatment due to complica- tions of wound infection, bleeding, severe painful or delayed healing were switched into the MEBO group for ethical reasons, and, despite the relatively late access to MEBO, these patients achieved the same satisfactory results. Therefore, it was concluded that treatment with MEBO throughout the clinical procedure for extensive burns patients was both feasible and safe. In addition, it indicated that when the treatment with SD-Ag for exten- sive burns patients appeared to be unsatisfactory, switch- ing them into a MEBO protocol was reasonable and ap- propriate. MEBO seemed to promote spontaneous heal- ing in the delayed-healing wound and was able to prevent or decrease the need for skin grafting. In conclusion, a clinical display of MEBT/MEBO on treating superficial and deep partial-thickness burns is shown in figure 50. In figure 51, the clinical procedure and display of MEBT/MEBO on treating facial full-thick- ness burns can be seen. Figure 52 is a clinical graphic report of the granulation tissue regenerating from burned bone wounds treated with MEBT/MEBO. Finally, a case report on the treatment of electrical injury with MEBT/ MEBO is shown in figure 53. 124 Burns Regenerative Medicine and Therapy Fig. 50. a Burns wounds of superficial and deep partial thickness degrees on the 1st day after injury. b Applying MEBO directly, treat- ment with MEBT. c On the 3rd day after burn. d On the 4th day after injury, the wound of superficial partial thickness degree has started to heal. The wound of deep partial thickness degree has started to be liquefied. e On the 8th day after burn, the wound of superficial par- tial thickness degree has healed completely. The wound of deep par- tial thickness degree has liquefied. f On the 8th day after burn, the wound of deep partial thickness degree has liquefied. g On the 12th day after injury, most of the necrotic tissue has liquefied and dis- charged and the wound of deep partial thickness degree has started to heal. h On the 15th day after burn, most of the deep partial-thickness wounds is healed. i On the 25th day after burn, the wound of deep partial thickness degree has healed completely. Experimental and Clinical Study on Burns Regenerative Medicine and Therapy with MEBT/MEBO 125 50 Fig. 51. a Patient with facial burns after exposure to flame. No pain sensation, no exudate is observed. b Histological examination of burns wounds showing full-thickness burns. c Perform ‘skin cultivat- ing and tension relieving’ with unique blade knife on burns wounds. (For fig. 51d–i see next page.) 126 Burns Regenerative Medicine and Therapy Fig. 51. d After cultivating, directly apply MEBO according to the procedure of BRT. e Day 2 postburn. After cleaning the burns wounds covered with MEBO, perform secondary ‘skin cultivating and tension relieving’ according to MEBT. f An excellent visual example of the process of wound liquefaction on day 12 postburn. g On day 18 postburn, the necrotic tissues were almost liquefied and painlessly discharged while subcutaneous tissues were allowed to regenerate new skin. h On day 27 postburn, some burns wounds healed with complete regeneration while other burn lesions were in the process of healing. i On day 50 postburn, burns wounds healed and skin regenerated physiologically. Note the symmetrical smile and the lack of scarring. Full sensation has returned. Experimental and Clinical Study on Burns Regenerative Medicine and Therapy with MEBT/MEBO 127 Fig. 52. a Appearance of burned tibia of left leg. b Removal of the necrotic tissues at the surface of the bone. c Removal of the necrotic periosteum and outer cortex of tibia with scraper and bone chisel. d Multiple holes drilled in the exposed tibia surface within a distance of 1.0 cm, deep to viable marrow cavity with minor bleeding. e Appearance of tibial surface after drilling. f Subsequent to the appli- cation of preserved soaked MEBO gauze to cover the wound, within a few days, small granulating buds grew up through the drilled holes. g With continuous treatment with BRT, the granulation tissue devel- oped and spread to form a granulated wound. Skin grafting was then performed to close the wound. 128 Burns Regenerative Medicine and Therapy Fig. 53. a This case involved sustained elec- trical injury to wrist and forearm. The pic- ture shows necrosis of anterior forearm muscles, radial and ulnar arteries. The in- terosseous artery was viable. The pressure pain point of the upper extremity was at the elbow. b After 55 days of treatment with BRT, the necrotic tissues were liquefied and discharged while the wound on anteri- or wrist at the site of defective muscles was filled with granulation tissue. The wound is now healing from its margins by epithelial migration. c In another case, a 9-year-old patient was injured by a 150,00-volt electric impulse on the head. The injury went deep into the skull. d Two days after the burn, the wound was cleaned and the necrotic tis- sue removed, then multiple holes were drilled into the skull followed by treatment with bone BRT. MEBO was applied direct- ly onto the wound. e Fifteen days after treatment with MEBT/MEBO, small gran- ulating buds grew up through the holes. f Twenty-two days of treatment with BRT and MEBT/MEBO, granulating tissue developed and spread to form a granulated wound and the new epithelial skin island appeared. g Follow-up picture 2 years later. The wound was healed and the skull was completely covered. OOOOOOOOOOOOOOO OOOOO OOOOOOOOOO OOOOO OOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOO O OOOOOOO O OOOO O OOOOOO O OOOOO O OOOO O OOOOOOO O OOOO OO OOOO Clinical Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 129 Fig. 54. a TBSA 100%, deep second-degree 6%, third-degree 94%, treatment with MEBT/MEBO. b Prof. Rong Xiang Xu evaluating and directing BRT treatment. c Posterior view of wounds during treatment. d The healing image (posterior). e The healing image (an- terior). Remarkably, rigorous sterile conditions are not re- quired if burns regenerative medicine and therapy (MEBT/MEBO) is used in the care of extensive burns patients. Basic equipment and general surgical conditions typically suffice. However, ambient room temperature of 32–36 ° C and careful, well-trained, intelligent nursing care are required so that removing liquefied product in a timely manner is accomplished. In general, surgical prin- ciples of systemic comprehensive treatment should be fol- lowed. Figure 54a–e shows Prof. Rong Xiang Xu, inven- tor of burns regenerative medicine and therapy (MEBT/ MEBO), as he assesses and directs the treatment for a burns patient with deep burns of TBSA 100%. 130 Burns Regenerative Medicine and Therapy OOOOOOOOOOOOOOO OOOOO OOOOOOOOOO OOOOO OOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOO O OOOOOOO O OOOO O OOOOOO O OOOOO O OOOO O OOOOOOO O OOOO OO OOOO Extensive Burns Cases with Most Wounds of Superficial Partial-Thickness Case 1 (fig. 55a, b) Fig. 55. Anterior (above) and posterior (below) views. a A 2.5-year-old baby patient, TBSA 70%. b Discharged with complete healing after treatment with MEBT/MEBO for only 14 days. Clinical Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 131 OOOOOOOOOOOOOOO OOOOO OOOOOOOOOO OOOOO OOOOOOOOOOOOOOO OOOOOOOOOOOOOOOOOOOOOOO O OOOOOOO O OOOO O OOOOOO O OOOOO O OOOO O OOOOOOO O OOOO OO OOOO Extensive Burns Cases with Most Wounds of Deep Partial-Thickness Case 2 (fig. 56a–f) Fig. 56. a A 21-year-old man, TBSA 98%. b 24 h after treatment with MEBT/MEBO. c, d Regeneration of skin tissue and wound healing on the 30th day after treatment with MEBT/MEBO. (For fig. 56e–f see next page.) 132 Burns Regenerative Medicine and Therapy Fig. 56. e At the present time. f Three years post-treatment, the form, structure and function of the new skin is identical to normal skin (chest and abdomen). Case 3 (fig. 57a–d) [...]... Extensive Burns Cases with Most Wounds of Full-Thickness Case 4 (fig 58a, b) Fig 58 a TBSA 94 % Before treatment b Wound healing on the 40th day after treatment with MEBT/MEBO 134 Burns Regenerative Medicine and Therapy Case 5 (fig 59a–c) Fig 59 a TBSA 93 % Before treatment b On the 9th day after treatment with MEBT/MEBO c One year later after being healed and discharged on the 46th day post-treatment... Clinical Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 135 Case 6 (fig 60a–c) Fig 60 a Upper and lower: TBSA 90 % Before treatment b Upper (anterior) and lower (posterior) views: All wounds healed with skin regeneration after 51 days of MEBT/MEBO treatment c At the present time 136 Burns Regenerative Medicine and Therapy Case 7 (fig 61a–c,... third-degree wounds (outside of right thigh and knee) There are few smooth and soft scars with slight hypo-pigmentation but good elasticity and no hyperplasia or dysfunction e The scars healed spontaneously from deep third-degree wounds (inside of right thigh and knee) Tissue appeared smooth and soft without contracture or deformity Case 8 (fig 63a–c, 64a–e) 138 Burns Regenerative Medicine and Therapy. .. superficial third-degree burns (inside of left upper arm) and recovered to normal structure and function c The skin healed spontaneously from superficial third-degree wounds (back) and almost recovered to normal in structure without obvious scars (For fig 62d–e see next page.) Clinical Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 137 Fig...Fig 57 a A 28-year-old patient TBSA 82% b During the treatment with MEBT/MEBO c Wound repair and physiological healing on the 32nd day after treatment with MEBT/MEBO Anterior and posterior views d At the present time Clinical Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 133 OOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOOO... 61 a TBSA 90 % Before treatment b The wound healed on the 43rd day after treatment with MEBT/MEBO c At the present time Fig 62 Three years later a The skin healed spontaneously from deep second-degree wounds (chest and abdomen) and had identical appearance as normal skin in structure and function Note the lack of scar tissue b The skin healed spontaneously from wounds mixed of deep second- and superficial . of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 135 Case 5 (fig. 59a–c) Fig. 59. a TBSA 93 %. Before treatment. b On the 9th day after treat- ment. fol- lowed. Figure 54a–e shows Prof. Rong Xiang Xu, inven- tor of burns regenerative medicine and therapy (MEBT/ MEBO), as he assesses and directs the treatment for a burns patient with deep burns. Demonstrations of Burns Regenerative Medicine and Therapy (MEBT/MEBO) on Successful Treatment of Extensive Burns 1 29 Fig. 54. a TBSA 100%, deep second-degree 6%, third-degree 94 %, treatment with