Quick Guide for Clinical Application of MEBO

Direct application of MEBO  – a specially  developed topical   drug  for  BRT  with  MEBT/MEBO –  onto   the wound  surface  to a thickness of 0.5–1.0  mm every 4–6 h.

Detailed clinical treatment is recommended as follows:

1. For first aid at home (especially in the kitchen):

Immediately apply MEBO on the wound to relieve pain, stop bleeding, alleviate injuries and  prevent infection in cases of scalds  and  burns  by hot oil, boiling  water,  or friction burns. The sooner,  the better. The consequent treatment should be conducted according to the follow- ing specific cases.

2. Treatment for  first-degree burns   or  scalds:  Directly smear MEBO onto the wound  2–3 times daily.

3. Treatment  for   superficial  second-degree  burns   or scalds:  

Directly smear  MEBO  onto  the  wound   to  a thickness of 0.5–1.0  mm.  Renew  the  ointment every 4–6 h; before doing so gently wipe off any residual oint- ment  and  exudates. It usually  takes  6–7 days to heal.

Blisters,   if  present,  should   be  punctured  and   dis- charged  while blister  skin should  be kept intact in the early stage.

No disinfectant, saline or water is required or in fact even allowed except in the case where exoge- nous toxins remain at the site such as might be the case with  chemical burns  or other  dirty  wounds.

Patients sustaining moderate or extensive burns  should  be sent to hospital or a clinic experienced with the BRT treatment  protocols.

4. Treatment for deep second-degree burns:

Treatment in the early stage is the same as that for superficial second- degree burns.  Remove the blister skin on day 5–6 after injury.  As the dermis  tissues are damaged and white in color, the application of MEBO should be continued on the  wound  to  a  thickness of 0.5–1.0  mm  every  4 h.

White metabolic products resulting from liquefaction of necrotic tissue  by  the  ointment will  appear on  the wounds  (do not  misdiagnose this  cleansing  process  as infection). Be sure that the residual ointment and white liquefied products are wiped off gently (do not irritate or debride the tissue)  before reapplying MEBO.

Allow another 6–7 days for the necrotic tissue to be liquefied and  discharged completely, then  continue the  above treatment using less dosage of MEBO until  the wound heals. In the event that the wound is still not healed after 25 days postburn, the diagnosis should  be changed  to full-thickness degree.  

In  brief,  the  venerable medical principle of ‘primum non nocere’ (first do no harm) and of ‘no secondary injuries’ should be honored during  the whole  treatment procedure.

We  accomplish that  by:
(1) protection of the  treated wound  in the  early stage from  further injuries (avoid  any measures which  may irritate, debride or exacerbate wounds);
(2) liquefaction and removal of the necrotic tissue without causing sec- ondary injuries;
(3) regeneration and  skin repair with- out causing secondary injuries (any method which may irritate or damage  the wounds  is not allowed).

Patients sustaining moderate and extensive burns should be sent to  hospital or  a  clinic  with  experience of  BRT  and MEBT for appropriate treatment.

5. Treatment for second-degree burns:  

For the small-area burn   wound, we  recommend  cultivating tissue  and then  preparing the  lesion  for  application of  MEBO through gentle loosening of necrotic tissues by scratch- ing  with  a  specially   designed device   –  ‘plough saw blade’  is the  appropriate treatment for  the  deep  sec- ond-degree burns  wounds.

For  larger  burns  wounds, the aforementioned method is adopted if the patient’s systemic condition is stable.  The  principle of ‘no sec- ondary injuries’  should  be followed  strictly during the treatment.

Patient sustaining third-degree burns  must be hospitalized at clinics  offering  care from  clinicians experienced in BRT with MEBT/MEBO.

6. In the  treatment of small  burns  wounds occurring in inconveniently exposed  body  parts, bandaging is rec- ommended.

However, dressing changes and renewal of MEBO ointment at a thickness of 2–3 mm every 12 h is recommended.

Contrary to the typical dressing  change protocol,  however, rather  than   debride  the  wound beneath the bandage, we recommend that  the bandage be gently  removed leaving  the  residual ointment and metabolic products to continue their  cleansing activity.

7. Treatment for other superficial trauma wounds includ- ing abrasion, friction burns, skin  cracking, and  stasis ulcers:

Treat the ulcer wounds according to the instructions   for   either   superficial  or  deep   second-degree burns, or dress the wounds with MEBO in accordance with the surgical  methods. However, any disinfectant, antiseptic or saline is contraindicated as they are both unnecessary and deleterious to wound  health.

8   Treatment for  hemorrhoids:  

Directly apply   MEBO onto  the affected area  every morning and  evening, or smear  MEBO onto the postoperative wound  to relieve pain and promote healing.