Management of the Burn Wound Environment
Burns regenerative medicine and therapy refers to
the
medical management up to the complex pathogenesis of burns.
Emphasis in
this volume is made on the therapeutics focus of local burns wounds, an
especially conclusive description.
Considering the management of the burns wound
environment, two techniques are currently available
worldwide for local burns treatment.
One option is based upon the perceived benefit of
maintaining the wound in a dry and dehydrated state
while the other strives to maintain the wound in a physiologically moist state.
Research clearly demonstrates that the former
compromises while the latter encourages
tissue regeneration.
Simply stated, one is pathological and the other
physiological as regards tissue repair.
In clinical treatment, careful consideration is
needed
for choosing the appropriate burn therapy according to the depth of the
burns wound.
For superficial burns, as long as pain is relieved
and
further injury is prevented, any burns therapy may achieve successful
results.
For deep second-degree and/or third-degree burns,
the
choice of therapy is more critical since pathological healing may
result in disability
and lifelong distress for the patient.
Due to differences of cultures and academic
ideologies
in the medical circles, two categories of burns therapy predominate in
treating deep burns wounds.
These are:
The former is symbolized by the therapy
established in
the 1930s, with the characteristic of excision and skin grafting (a
variety of autografts) for wound closure.
As the main stream in the western medical
circles, this therapy has been adopted in hospitals all over the
world.
The latter, burns regenerative medicine and
therapy, involves two modalities: moist-exposed burns
treatment (MEBT) and moist-exposed burns
ointment (MEBO).
This innovative and impressive modality was
established by Dr.
Rongxiang Xu in the late 20th century.
It features the discharge of
necrotic tissue by
liquefaction in a manner that does not cause further
secondary injury
and also supports the establishment of a physiological environment
sufficient to repair residual viable tissues while regenerating skin
tissue.
This therapy has been successfully exported to 48
countries and enjoys wide clinical application while attaining the
predominant status for burns care in eastern medical circles.
Herein to follow are the main points of the two
categories of the burn therapies.
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