1. 3.5. Explain the key stages of MEBO’s biochemical reaction on the wound
    • 2010/10/27 10:57:18
    In burns treatment, after MEBO applied on the burn wound, the liquid formed MEBO reacts with necrotic tissues on burn wound, and then MEBO loses the lipophilic character and mixes with exudation and liquefactive stuff, then the mixture moves to the outer layer of MEBO and be discharged out of skin. The new upper layer of MEBO continues to be warmed up and transformed to liquid form and then Hydrolysis, Enzymolysis, Rancidity, Saponification and Esterification happen sequentially, repeatedly and drainage automatically. This is the main mechanism of liquefaction of burn wound necrotic tissue. (ref.)
    A.  MEBO is warmed up and surrounds necrotic tissues: First, the grease base of solid form MEBO is warmed up by wound temperature and transformed to the liquid form; the oil is released and flows into the burn wound, divides the necrotic tissue into pieces and surrounds them, which will initiate the series chemical reactions between MEBO and necrotic tissues.
    B.  Hydrolysis: The first reaction is hydrolysis (One compound is decomposed under the effect of water.) The remaining water in necrotic tissues reacts with the necrotic skin under the effect and surrounding of MEBO, which will further initiate the series chemical reactions.
    C.  Enzymolysis: There are kinds of zymngens in remnant cells in burn wound necrotic tissues. Zymngens are the non-activate prosome of enzymes. After hydrolysis, the peptide of the zymngen in charge of the non-active function is removed.  Then the big molecules such as protein, fat, carbohydrate are digested into small molecules by several kinds of enzymes. Thus, the necrotic tissue on burn wound is changed into molecular level. 
    D.       Rancidity and saponification: Based on organic chemistry, acid and alkali chemical reactions are the reaction that obtain or lose electron (s). Rancidity reaction means that the amino acids, fatty acids are separated, the aldehyde keton oxide are formed from protein, fat tissues after the above-mentioned reactions.  All these acidity compounds are composed by hydrogen ion and acid radical.  These organic acids produce neutral salt and water after decomposion and combination.  Saponification means the fat hydrolyzes in the alkalescence solution and produces glycerol and fatty acids.
    Burns can make the wound tissue denaturalized and necrosis, produce lots of histamine, bradykinin, lactic acid, free radical and other acid substances, which are called “Burn toxin". Under the therapeutical effect of MEBO, the burn toxins are decomposed, so that the direct damage of the wound are relieved; more addition, it reduces the damages of multi organs in the body by absorption of burn toxins. In one word, the result of rancidity and saponification is to decompose the necrotic tissue into neutral substances, which will protect the wound efficiently and alleviate the damage of burn toxins after absorption. 
    E.        Lipofication and Esterification: The necrotic tissues are transformed into liquid form after above-mentioned reactions. The liquid necrotic tissues then react with surrounding MEBO and perform lipofication and esterification, which will ensure the necrotic tissue be liquefied and discharged from the wound eventually.  MEBO has net-like frame form. It's composed by grease and surrounding beeswax.  There are abundant linoleic acids (belongs to non-saturation acid), which can be decomposed with sterol stuff, aldehyde oxide, keton oxide, lipid, adipoidand, etc. This process is called “lipofication". After that, the linoleic acids in MEBO bind with those substances and form esters, this is “esterification".
    In the process of liquefaction, esters can be degraded into acids; the opposite reaction is the acids are transformed into esters under the effect of esterases. The acid burn toxicity in necrotic tissue is reduced through these reactions, which also protect the moist physiological environment of burn wound and prevent its further damage. More addition, esters compound can protect surviving tissue of burn wound, promote wound healing and cultivate the neo regenerated skin tissue. Thus, it can be seen that Lipofication and Esterification are reversible biochemical reactions happening one after another. In this step, the decomposition between grease (linoleic acids) and liquefactant of necrotic tissue is not only the main base of burn wound moist physiological environment, but also the main elements which promote decomposition and liquefaction.  After that, the necrotic tissue are transformed into liquid form of esters liquid mixture, the toxicity and irritation are much reduced and the mixture are easily to be discharged, which ensures the process of skin organ regeneration in situ.
    The biochemical reactions of MEBO occurred in the burn wounds enable necrotic skin tissue particles to become liquefied mixtures, so that necrotic skin tissues can be removed without causing any further damages through local application of the drug according to MEBT, to ensure regenerative repair of the wound. All this ensures the physiological wound healing without scar. To be emphasized, in order to fulfill the clinical effect of BRT & MEBT/MEBO, not only the correct and standardized application of BRT is a requirement in local wound, but also the procedures and techniques of systemic BRT, they assistant to each other.