1. 2.2.2 Why is water or normal saline not recommended to clean wounds during MEBT/MEBO treatment?
    • 2010/10/25 11:34:39
    The standard clinical application of MEBT/MEBO requires maintaining a physiological moist environment on the wound, i.e. the micro-environment of the wound should be similar to the internal environment of the human body in composition, temperature, pH Value and osmotic pressure, with the most indispensable principle of iso-osmia with the human internal environment.
    After burns, burn wounds especially those with the necrosis and defluvium of epidermis will lose the isolation and protection of the epidermis, leaving tissue cells in the deep layer exposed to the external environment. When tissue cells are contacting with water (only consisting of H2O, i.e. aqua pura is a type of hypotonic liquid), hydropsia, dysmorphia, denaturalization and even necrosis will occur; moreover, water (especially cold water) is another stimulating factor, which can lead to local vasoconstriction, microcirculation stasis, etc.. All these can damage the tissue cells and thus deepen the burns wound. Therefore, water is not recommended for burns wound.
    Normal saline (NS), a single solution composed of 0.9% sodium chloride solution with PH of 5.0, also greatly differs in the composition from the plasma, which is a eco-fluid composed of various crystalloid and colloid solutions and microelements with PH of 7.35~7.45. It is commented by experienced doctors that normal saline is actually not physiological at all. Therefore NS is also unsuitable for the wound except for the seriously contaminated wound.
    MEBO can be applied directly on the wound without obvious contamination. The process of ointment melting can automatically absorb the residual heat from the wound to reduce stimulation, relieve pains, improve micro-circulation and save the parabiotic tissues. Clean the wound afterwards by dipping with aseptic dressing, so that the wound is naturally clean. This process is so called MEBO undamaging debridement method, which has been widely used in domestic medical treatment network currently.