Deep Second Degree Deep (DIID) Burns Wounds
Treatment of BRT with MEBT/MEBO
The clinical signs of deep second-degree burns are
similar to those of deep
second-degree superficial burns, except that
DIID has more serious injuries and more serious response during the
liquefying period and therefore the reconstruction and regeneration of
wounds become more complicated.
The clinical treatment for deep second-degree
burns also can be divided into four periods.
Clinical signs – no extensive blisters,
entirely destroyed and adherent to injured dermis, the wounds free of
putrid skin are no longer sensitive to pain, the wounds are white, with
Some of the wounds may be red alternating with
white, but the color-changing response to pressure is very
This period begins from the first day of burn
the 7th day postburn. During this period, simply apply MEBO to protect
From day 7 to day 20 postburn, clear away all
substances to expose necrotic dermis and apply BRT with MEBT/MEBO
immediately. For small wounds, simply use this treatment to liquefy and
discharge the necrotic layer.
For large burns, simple de-bridement should be
coordinately. The necrotic layer is so deep that the wound liquefying
may be incomplete and cause lumps exfoliation of necrotic tissues,
which need to be cut with surgical scissors and removed.
Attention should be paid to keep a certain
distance between the surviving viable tissue and the cutting.
Any further damage to the surviving viable tissue
as bleeding (which may cause infection) should be absolutely
Simple debridement can be adopted according to the
condition of the wounds.
When the necrotic layer is almost completely
clean away the liquefaction products in time to ensure that the
non-smooth survival tissue is kept in a MEBO environment, but not in an
environment filled with liquefaction products.
The period of reconstruction and regeneration of
residual dermis tissue.
As little residual dermis tissue is left and the
frame is fundamentally destroyed, correct BRT with MEBT/MEBO is quite
vital in this period.
The reconstruction of dermis tissue involves three
reconstruction of vascular tree;
reconstruction of fibrous tissue dependent on vascular tree;
regeneration of skin appendages, gland tissue, formation of excretory
ducts, and formation of skin tissue.
Any careless injuries and pressure to the wound
are forbidden. This period usually happens on days 20–28
Aiming at helping the healed skin return to
treatment in this period varies according to burns severity and skill
in the treatment.
The severe injuries to skin and the factors
the skin during reconstruction make the newly healed skin quite
different from normal skin in structure, appearance and
So the rehabilitation
very important, including two aspects: ‘protective therapy
healed skin’ and ‘functional
The former is accomplished by adjusting the
structure of newly regeneration skin tissue with the application of MEBO Scar Lotion, by
adjusting the function with MEBO
Cleansing Cream, and by killing itch with MEBO Itching Reliever
just after the wounds heal.
At early stage, the treatment is the same as that
second superficial type
Remove the necrotic skin 5 days later.
Because the dermis layer has been injured, wounds
appear wax-like white.
Continue applying MEBO with the thickness of less
than 1mm. Redress every 4
After applying MEBO, there would be liquefied
necrotic tissues exudates on wounds.
It is a normal phenomenon and do not mistake it as infection.
Remember to clean the residual drug and white
liquefied exudates on wounds with disinfected gauze before redressing
About 15 days later, necrotic tissues are
liquefied and discharged.
layer of fabric isolating membrane on wounds should
Continue applying MEBO according to method
mentioned above to protect the layer of membrane until wounds are
healed with flat skin.
If wounds are not healed after being treated for
more than three weeks,
it indicates that the wound is superficial
third degree burn and should be treated with corresponding
1. After simple debridement, apply MEBO
immediately to protect wounds.
2. On 5th day postburn, remove necrotic skin. Necrotic tissues on
wounds are liquefied and discharged.
3. A layer of fabric
isolating membrane forms on wounds under the action of
4 . Apply MEBO complying with the principle of "Three No" (Don't
cause pain, Don't cause bleeding and Don't cause any further damage in
the normal skin tissue) and protect
the membrane to promote repairing of wounds.
5. On 30th day postburn, burn wounds regenerate and repair.
6. Continue applying MEBO for 10-15 days to protect healed skin.