The formation of a physiologically moist environment on burn wounds

In course of the application of BRT & MEBT/MEBO to promote liquefaction and removal of necrotic tissue in burn wound, a physiologically moist environment is formed simultaneously.

After discharge and liquefy of necrotic tissue, a layer of transparent, cornea-like fibrous isolation membrane is formed on the wound surface. 

The presence of this membrane is a sign of the formation of physiologically moist environment.

This membrane protects the viability of the skin tissue organs regenerated from stem cells in situ, so that it is important to protect this membrane in order to ensure physiological regenerative repair of the burn wounds.

Experiments proved that when the wounds were protected by MEBO phls fibrous isolation membrane, the evaporation of the burn wound tissue is approximately the same as that of the normal skin. 

This membrane protects the injured wounds and helps wound respiration.

This is quite different from dry therapy and vaseline treatment, the burn wounds do not lose a lot of water as treated with dry therapy and the tissues are not suffocated and macerated as treated with vaseline.

The formation of fibrous isolation membrane: 

MEBO has good compatibility with burn wound exudates and can form a fibrous isolation membrane in the course of wound necrotic tissue liquefaction. The membrane is composed of lipoids produced by the biochemical reactions of MEBO and lipoproteins complexes produced by exudates of plasma protein from wounds. The membrane tightly covers the wound surface, so that the neo regenerative stuff can attached to it and the wounds can be repaired in a regenerative way in physiologically moist environment.

fibrous isolation membrane burn wound

The characteristics and function of the fibrous isolation membrane: 

As a "semi-permeable" membrane, the special composition of the fibrous isolation membrane enables its unique characteristics and function. 

It lies in between wound surface and MEBO. 

In both sides of the membrane, osmotic pressure is formed respectively. 

One side is hydrophilic (wound tissue) and the other side is lipophilic (MEBO). 

Exchanges of materials as ions are taking place, so that the metabolism products of the wounds can be excreted into the outer side of the membrane. 

Through the same mechanism, the nutritive and biologically active components of MEBO can go into the deep layer of the wounds and to give full play of its physiological and pharmacological effects to promote skin tissue regeneration and repair.

Clinical significance of fibrous isolation membrane: 

The whole process of burn wound regenerative repair in situ is completed by the protection of the fibrous isolation membrane under the standardized application of BRT & MEBT/MEBO. 

Only under the protection of the isolation membrane could the microcirculation in the deep layer of the wound be regenerated in the frame of physiological capillary tree, so that nutritive materials could be transferred to the primitive skin blastemata and skin islands, which were regenerated in situ by stem cells and developed and expanded to heal the wounds. 

Serious attention should be taken during change of dressings, washing and cleaning, to keep the fibrous isolation membrane intact. 

The wounds should be kept in physiologically moist state, not dried nor macerated, through continuous supply of the drug. 

That's why the principle of "three no injury" and "three no accumulation" in wound management was suggested.