Trauma wound therapy

Key Points of Wound Management at each stage with Regenerative Medicine and Therapy (MEBT/MEBO)


3.1. Key points of wound management during the exudation stage (early stage):
Principle: cleanse wounds and extremely protect the living tissues. During this stage, it should fully exert the debriding function of MEBO Wound ointment or MEBO Wound and Ulcer Dressing as the cleansing agent that either effectively cleanse the wound or protect the normal and healthy tissues. Major pathological changes within the first 72 hours after injury include: contamination, blood clots, necrotic or dead tissues, foreign bodies and etc. Perform debridement; for the low-contaminated, good shape and no tension wounds, the first suture should be performed best within 6 hours after injury or change the large wounds to the smaller one, then apply the MEBT/MEBO with MEBO Wound Ointment or MEBO Wound and Ulcer Dressing at the local site to realize the in situ regenerative restoration.  For the contaminated wounds, the suture should be delayed after debridement, and directly apply the MBET/MEBO; if the wounds fulfill the criteria as cleaning wound within 72 hours post-injury, suture the wound completely or partially, the exposed part also needs to be given the MEBT/MEBO with MEBO Wound Ointment or MEBO Wound & Ulcer Dressing; For crush injuries and the wounds with gas gangrene, the wound should be opened. Do not perform suture and bandage. Administer Moisture Exposed Therapy and debridement: that is to say, remove those apparent dead tissue and pay attention to the protection of the parabionic (inter-survival) tissues.
3.2. Key-points of wound management during the stages of inflammation, infection and ulceration
Inflammation is one factor for the onset of wound. During this stage, it would appear the clinical manifestations, such as local inflammation, infection and ulceration. The main pathological changes are the occurrence of acute specific infection (with four days post-injury, such as gas gangrene), chronic noe-specific infection and rejection (type-III immune response). It should be given MEBT/MEBO as local treatment (administer MEBO Wound Ointment or MEBO Wound & Ulcer Dressing that will liquefy the necrotic tissues, cleanse the liquefaction properly without damage to normal tissues, prevent and control the occurrence and development of local infection; maintain the patent drainage of the wound, timely detect and remove the separated necrotic tissue. Prior to the arrival of the peak phase of immune response that is around the 15th day post-injury, it should thoroughly liquefy and discharge the necrotic tissue to prevent the occurrence of severe rejecting infection and new infection.   
During the stage of chronic infectious ulceration, there are exudates on the wound bed, pale and ageing granulation without vitality, cessation of growth and edema, formation of basal fibrous layer with hardness, contracture and no elasticity and formation of surrounding fibrous ring that will take effects on the blood circulation and lymphatic returns. More severe the granulation tissues, more solid the basal fibrous layer, then it is harder for the blood stream to pass the fibrous layer; as the congested venule in the edematous granulation tissues cause the obstruction of venous return, in association with deficiency of lymphatic returns, the over-excessive hyperplesia of granulation tissue will be caused and aggregates the swelling. The above process is the significant factor to the formation of the edema of granulation tissues. If the above course could not be improved or corrected, with the occurrence of fibrosis, it would cause the deficient perfusion of local circulation, the drop of skin oxygenation, the lengthening of dermal papilla and the production of polyp-like hypertrophic injuries that will extensively result in the deficiency of circulation, formation of ulcers and even aggregation of ulcers that are refractory. The main pathological change is the chronic inflammatory process not rejection on the granulation tissue; the principles of interventions: apply MEBT/MEBO on the wound, administer topical MEBO Wound Ointment or directly place MEBO Wound & Ulcer Dressing, remove ageing dead fibrous ring as necessary to promote the regenerative restoration of new granulation tissue and the healing of the wound.
3.3. Rehabilitation stage:
Principle is the protection of new granulation tissues, promotion of rapid physiological healing or restoration on wounds). During this stage, MEBO Wound Ointment or MEBO Wound & Ulcer Dressing is considered as culture medium that should be fully exerted. (for the penetrating traumas, the rehabilitation stage is from the 72nd hour to 1 or 2 weeks; for blunt traumas, it is within 3 weeks post injury; for those wounds with the necrotic tissues that are not timely cleansed, causing the rejection from necrotic tissues or ulceration, the rehabilitation stage is extended to the fourth week post injury; Once the wound is in the rehabilitation stage, it means the necrotic tissues have been eliminated with the formation of granulation tissues as barrier. The major pathological and physiological change is the process of normal physiologically regenerative repairing. At this stage, it should protect the new tissues. It can perform auto-grafting to shorten the hospital duration and seal the wound as necessary. The major pathological and physiological change of is by the action of proper technique (MEBT/MEBO), chronic inflammation process stop, regenerative mechanism is initiated and in situ self-renew the tissue cells and regenerate the second life cells. Principle of interventions: protect the fresh wounds with the application of in situ skin regenerative restoration techniques (MEBT/MEBO), including the topical administration of MEBO Wound Ointment or MEBO Wound & Ulcer dressing to induce the wound to be physiologically regenerated and restored in the model of embryonic development.