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:

1. ‘surgical excision and skin grafting therapy’, and
2.  ‘conservative repairing therapy (burns regenerative medicine and therapy)’. 

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.

Surgical Excision and Skin Grafting Therapy
a purely surgical technique and functions with disregard to burns physiology

Burns Regenerative Medicine and Therapy with MEBT/MEBO
MEBT was invented on the basis of a series of burns natural pathogeneses, appreciating each aspects of burns tissue’s physiological response including physical, chemical and biochemical reactions.