partial-thickness acute burns management trend

1. Moist Non Exposed
Burn wound Ointment
(MNEBO) THERAPY IN
DERMAL BURNS
By; Dr. Qutaiba Abdulah Aldori
At AZADI Burn Unit
Kerkuk- Iraq

2. Defenitions
• MEBO THERAPY : Management of
partial thickness burn wound by
Moist Exposed Burn-wound
Ointment
• MNEBO THERAPY: Management
of partial thickness burn wound
by Moist Not Exposed Burn-
wound Ointment

3. INTRODUCTION
• A burn wound is a dynamic, evolving injury rather
than a static one.
• The way by which healing taken is depending on
several majors and many minor factors

4. INTRODUCTION
• The depth of a burn wound and/or its healing
potential are the most important determinants of
the therapeutic management and of the residual
morbidity or scarring.

5. INTRODUCTION
• Traditionally, burn surgeons divide burns
into superficial which heal by rapid re-
epithelialization with minimal scarring
and deep burns requiring surgical therapy

7. Three key methods FOR the
management of partial thickness burns
• a) surgical debridement and coverage with
autograft;
• b) surgical debridement & Coverage with skin
substitutes such as Biobrane™
• c) Regular dressing changes to wait for
autolytic debridement and eventual
reepithelisation.

8. Three key methods for the
management of partial thickness burns
• Most modern burns unit prefer methods (a)
and (b) as the method (c) results in a
prolonged stay in hospital and increases
chance for development of hypertrophic
scarring.
• BUT hear in our developing countries and in
large population countries still using method
(c) even in USA & CHINA .

9. Method (a)Early Excision & StSG

10. Method (b) Early Excision & Biobrane

11. Draw back of trend
(a & b)
•

12. Auto Grafting or Biobrane
• MUST NOT be applied
• 1) when wound contamination
• 2 necrotic material persists .
• 3)signs of infection are present .
• 4) heavy bleeding is ongoing.
• Risk of failure increases if application >24 hours
post-burn, significantly increases >48 hours or
outside theatre.

14. Method (c)
• Regular dressing changes to wait for autolytic
debridement and eventual reepithelisation.

15. Regular dressing changes to wait
for autolytic debridement
and eventual reepithelisation.

53. Methods and
Materials

57. The good things of this trend
• Dr. loannovich J. 3 finding that;
• MEBO contributes to a better quality scar after
epithelial repair than other local agents.
• Local substances applied to burn wounds may
provoke a debriding effect. In a moisturized
environment where eschars are easy to remove in
small pieces MEBO showed an efficient debriding
effect compared with the other agents.

58. The good things of this trend
• MEBO significantly accelerates the wound healing
process in partial-thickness burns
• Measurement of moisture in the wound may give
additional information regarding the wound healing
process. MEBO manifests a moisturizing
environment for a longer period than other
substances

59. The good things of this trend
• ChuanjiU, Yunying,' and Rongxiang' have indicated
that MEBO has the following therapeutic effects:
• Analgesic: MEBO reduces pain in partial-thickness
burn wounds;
• Anti-shock: MEBO reduces evaporation of water
from the burn wound surface and improves
microcirculation by decreasing peripheral and
systemic capillary exudation;

60. The good things of this trend
• Anti-bacterial: MEBO changes the biological
behavior of bacteria, inducing a decrease in
bacterial toxicity and invasive capacity, as well as
sensitivity to antibiotics; it also increases the
wound's local and systemic immunity;
• MEBO promotes epithelial repair; it also reduces
healing time in partial-thickness bums;
• MEBO improves scar formation and contributes to
the formation of a smooth, thin, and aesthetically
acceptable scar; it thus prevents the formation of
hypertrophic scars.

61. The good things of this trend
• Summery
• Analgesic
• Anti-bacterial
• better quality scar
• Eschars are easy to removed
• Accelerates the wound healing
• Moisturizing environment for a longer period
• Reduces evaporation of water (Anti-shock).

62. SMILING
DURING
DRESSING
CHANGE NO
PAIN

63. Draw back of trend
(c)
•

64. Change nylon 3 times a day for 15-28 days
depend on % & degree

65. •“If I have seen further
it is by standing on
the shoulders of
giants”
• – Isaac THANK YOU