A New Approach to Local Burn Wound Care: Moist Exposed Therapy. A Multiphase, Multi-center Study

Atiyeh BS, et al.  Journal of Surgical Wound Care 2003; 2(1): 18-27
 
MEBO was tested on healing of split thickness skin graft donor sites and compared to semi-open (Sofra Tulle) and a semi-occlusive (Tegaderm) dressing.  Healing with the ointment was observed within 5-8.9 days versus 10-13 days for the other dressings.  Scar assessment scores demonstrated significantly better scars for MEBO at 1 month (p<0.001) as compared to Tegaderm.  The difference was significant (p<0.05) at 2 and 6 months. 
 
Subsequently, two clinical trials on burn patients were conducted. MEBO application resulted in a statistically significant (p<0.001) decrease in overall treatment costs as compared to other topical treatment modalities.  The most significant cost reduction was observed in the utilization of medical facilities (p<0.0001).  The trials elaborated the practicality of MEBO therapy and its effectiveness in preventing burn wound sepsis.  Initial swab cultures were positive in 29% of the immediately treated patients and 92% in patients treated on the third post burn day.  By the second week, bacterial colonization dropped to 5% and 23% respectively.
 
It is not conceivable to abandon products and methods currently in use for local burn wound care whose benefits have been well documented unless additional benefits of the new product can well be elaborated.  Our first concern was to demonstrate that the new moisture retentive ointment has a good antibacterial effect.  Second, it was important to prove its moisture retentive capacity and its positive impact on wound healing as it applies to burn wounds.  Third, it was crucial to determine whether the use of this ointment could be practical and cost-effective.

Though it is not an antibiotic, adequate local antibacterial action of the ointment has been demonstrated in a previously reported experimental study.  In a parallel study it was shown that prolonged use of MEBO 
does not seem to lead to the emergence of resistant strains.  Improved healing potential of the ointment has been demonstrated in previous clinical studies.  The clinical value of the moisture retentive ointment in autolytic debridement and healing of burn wounds has been elucidated in clinical trial 1.  Clinical trial 2, on the other hand, stressed the practicality and cost-effectiveness of the ointment in local wound care.  Adverse side effects to the ointment was observed in clinical trial 1 in only one female patient who developed itching and presented with flushing of her face following the second day of application.  All symptoms subsided as soon as application was discontinued.