Deep Second Degree Deep (DIID) Burns Wounds Treatment of BRT with MEBT/MEBO

The clinical signs of deep second-degree burns are sim- ilar  to  those   of  deep  second-degree superficial  burns, except that DIID has more serious injuries and more seri- ous response during the  liquefying period and  therefore the  reconstruction and  regeneration of wounds become more  complicated. The  clinical  treatment for  deep  sec- ond-degree burns  also can be divided into four periods.

First Period. Clinical signs – no extensive blisters, epi- dermis entirely destroyed and adherent to injured dermis, the wounds free of putrid skin are no longer  sensitive to pain,  the wounds are white,  with  little  exudate. Some of the  wounds may  be red  alternating with  white,  but  the color-changing response to  pressure is  very  slow.  This period begins  from  the first  day of burn  through the 7th day postburn. During this period, simply apply MEBO to protect the wound.

Second  Period. From day 7 to day 20 postburn, clear away  all adhering 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  used   coordinately.  The  necrotic layer is so deep that  the wound  liquefying may be incom- plete  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  such  as bleeding (which may cause infection) should be absolutely avoided. Simple  debridement can  be adopted according to the condition of the wounds. When the necrotic layer is almost  completely liquefied, 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 envi- ronment filled with liquefaction products.

Third  Period. The period of reconstruction and  regen- eration of residual dermis tissue.  As little residual dermis tissue  is left and  the dermis frame  is fundamentally destroyed, correct BRT with MEBT/MEBO is quite  vital in  this  period. The  reconstruction of  dermis tissue  in- volves three  parts:  (a) the reconstruction of vascular tree; (b) the reconstruction of fibrous tissue dependent on vas- cular  tree; (c) the 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 postburn.

Fourth  Period.  Aiming  at helping  the  healed  skin  re- turn  to  normal, the  treatment in  this  period varies  ac- cording to burns  severity and  skill in the treatment. The severe  injuries to skin  and  the  factors  affecting  the  skin during reconstruction make  the  newly healed  skin  quite different from  normal skin  in structure, appearance and function. So the rehabilitation is very important, includ- ing two aspects:  ‘protective therapy for healed  skin’ and

‘functional exercise’.  The  former is accomplished by ad- justing 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 for deep second superficial type degree burns

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 hours. 

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 each time. 

About 15 days later, necrotic tissues are liquefied and discharged. 

Then a layer of fabric isolating membrane on wounds should form. 

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 method.


1. After simple debridement, apply MEBO immediately to protect wounds.

mebt mebo deep second degree deep burns

2. On 5th day postburn, remove necrotic skin. Necrotic tissues on wounds are liquefied and discharged.

mebt mebo deep second degree deep burns

3. A layer of fabric isolating membrane forms on wounds under the action of MEBO.

mebt mebo deep second degree deep burns

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.

mebt mebo deep second degree deep burns

5. On 30th day postburn, burn wounds regenerate and repair.

mebt mebo deep second degree deep burns

6. Continue applying MEBO for 10-15 days to protect healed skin.

mebt mebo deep second degree deep burns