The process of
necrotic tissue liquefaction using MEBT/MEBO
The solid
necrotic tissues can be changed to liquid form
(Liquefaction),
and then discharged from the wound under the effect of
MEBO.
Before we annotate the process of liquefaction, we
need to
introduce the pharmacological effect of the special frame form of MEBO
(low melting point).
This frame form is alterable depending on the
change of wound
temperature: MEBO is an ointment at Room Temperature.
After applied onto the wound for the thickness of
1mm, there are two
layers of MEBO:
the outer side of MEBO keeps "ointment form"
the
wound-touched side is wanned up and transformed to liquid form.
MEBO
has the lipophilic character.
After applying, the liquid fonn MEBO
reacts with necrotic tissues on burn wound, and then MEBO loses the
lipophilic character and mixes with exudation and liquefactive stuff,
then the mixture moves to the outer layer of MEBO and be discharged out
of skin.
This is the main mechanism of liquefaction of
burn wound necrotic tissue.
A. MEBO
is warmed up and surrounds necrotic tissues:
First, the grease base of solid form MEBO is
wanned up by wound temperature and be transformed to liquid form.
The oil is released and flows into the burn wound,
divides the necrotic tissue into pieces and surrounds them.
It will initiate the series chemical reactions
between MEBO and necrotic tissues.
B. Hydrolysis:
The first reaction is hydrolysis (One compound is
decomposed under the effect of water.)
The remain water in necrotic tissues react with
the
necrotic skin under the effect and surrounding of MEBO, which will
further initiate the series chemical reactions.
C. Enzymolysis:
There are kinds of zymngens in remnant cells in
burn
wound necrotic tissues. Zymngens are the non-activate prosome of
enzymes.
After hydrolysis, the peptide of the zymngen in
charge of the non-active function is removed.
Then the big molecules such as protein, fat,
carbohydrate are digested into small molecules by several kinds of
enzymes.
Thus, the necrotic tissue on burn wound is changed
into molecular level.
D.
Rancidity and saponification:
Based on organic chemistry, acid and alkali
chemical reactions are the reactions that obtain or lose electron
(s).
Rancidity
reaction
means that the amino acids, fatty acids are separated, the aldehyde
keton oxide are formed from protein, fat tissues after the
above-mentioned reactions.
All these acidity compounds are composed by
hydrogen ion and acid radical.
These organic acids produce neutral salt and water
after decomposion and combination.
Saponification
means the fat hydrolyzes in the alkalescence solution and produces
glycerol and fatty acids.
burns
can make
the wound tissue denaturalized and necrosis, produce lots of histamine,
bradykinin, lactic acid, free radical and other acid substances, which
are called "Burn toxin".
Under the therapeutical effect of MEBO, the burn
toxins
are decomposed, so that the direct damage of the wound are relieved;
more addition, it reduces die damages of multi organs in the body by
absorption of burn toxins.
In one word, the result of rancidity and saponification
is to decompose the necrotic tissue into neutral substances, which will
protect the wound efficiently and alleviate the damage of burn toxins
after absorption.
E.Lipofication
and Esterification:
The necrotic tissues are transformed into liquid form after above
mentioned reactions.
The liquid necrotic tissues then react with surrounding MEBO and
perform lipofication and
esterification, which will ensure the necrotic tissue be
liquefied and discharged from the wound eventually.
MEBO has net-like frame form. It's composed by grease and surrounding
beeswax.
There are abundant linoleic acids (belongs to non-saturation acid),
which can be decomposed with sterol stuff, aldehyde oxide, keton oxide,
lipid, adipoidand, etc. This process is called "lipofication".
After that, the linoleic acids in MEBO bind with those substances and
form esters, thiis is "esterification".
In the process of liquefaction,
esters can be degraded into acids; the opposite reaction is the acids
are transformed into esters under the effect of esterases.
The acid burn toxicity in necrotic tissue is reduced through these
reactions, which also protects the physiologically moist environment of
burn wound and prevent
its
further damage.
More addition, esters compound can protect surviving tissue of burn
wound, promote wound healing and cultivate the neo regenerated skin
tissue.
Thus, it can be seen that Lipofication and Esterification are
reversible biochemical reactions happening one after another.
In this step, the decomposition between grease (linoleic acids) and
liquefactant of necrotic tissue is not only the main base of burn wound
moist physiological environment, but also the main elements which
promote decomposition and liquefaction.
After that, the necrotic tissues are transformed into liquid form of
esters liquid mixture, the toxicity and irritation are much reduced and
the mixture are easily to be discharged, which ensures the process of skin organ regeneration in situ.
The biochemical reactions of MEBO occurred in the burn wounds enable necrotic skin tissue particles
to become liquefied
mixtures, so that necrotic skin tissues can be removed without causing any further
damages through local application of the drug according to
MEBT, to ensure regenerative
repair of the wound.
All this ensures the physiological wound healing without scar.
To be emphasized, in order to fulfill the clinical effect of BRT
& MEBT/MEBO,
not only the
correct and standardized application of BRT is a
requirement in local wound,
but also the
procedures and techniques of systemic BRT, thiey assistant
to each other.
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