续前篇置疑里没有说透的话——再与星月商榷

< align=left>. “响鼓不用重锤”、“给人留面子余地”是与人为善的我处世原则之一。为此，上篇与星月商榷的帖子我留了没有说或是没有说透的话，现在看来有说完它们的必要。

< align=left>   星月多次提到你夫人的脓皮病是被你用烧伤膏治愈的。但是在临床上，凡对有渗出、尤其是脓性渗出的肌肤病灶原则上是禁用必含凡士林的软膏剂型的，记得多年前实习时，带教老师一再强调这一点，故印象很深。原因很简单：用通俗点话来解释有“沤烂”加重感染之虞，此时应该使用的是有收敛、吸收作用的洗剂、溶液剂或水相霜剂等。听P友说星月推荐的这种烧伤膏油性很重，本人不由对星月为自己妻子治疗脓皮病时勇于创新的精神表示钦佩。
   不好意思，这一点本人上次曾想到要置疑的，但出于对你......的顾及，再说也考虑到P友得上脓皮还敢擅自用药的几率毕竟很少，也就按捺住了这第一句想说的冲动。
   本人在上一篇质疑里曾经提到烧伤的体表面积与P的病灶之广泛无法并论的意见，现做进一步简要阐述，让论坛里这段时间熟稔了“烧伤膏”的P友们也对烧伤知识略知一二：
   烧烫伤的体表面积大于10%时便应视为严重，可以发生疼痛性休克。大于30-40%则危险性已很大，可以下病危通知书了；大于70%大多死亡。
   烧烫伤的危险性已经不是在肌肤上。它致命处是剧痛与渗出导致的微循环障碍、水电解质紊乱引发的休克，以及后期的感染、败血症、脏器功能衰竭而引发的死亡。
   故此，对于大面积的烧伤，首当其冲是全方位的防治休克抢救生命的治疗，清创以及外用药是后一步的事情了。
   这就是我说的对大面积烧伤患者不可能以烧伤膏作为主要治疗药物，故而其用量及其花费不可能与往往需要全身广泛面积使用的P相提并论的原因了。
   其实我在前篇强调这些的真正原因，是我还忍下了第二句话没有说：当对一种药物真正成分还不是很清楚时，哪怕是外用药也应特别注意不要长时间大面积使用。因为皮肤的吸收功能是不容忽视的！
   最后还有第三句前篇没有说透的话：星月说烧伤膏治好了他夫人脸上的“黑头”。在皮肤科，黑头俗称“黑头粉刺”，其医学名称是“痤疮”。用油性很重的烧伤膏治愈了发生在毛囊皮脂腺上的痤疮，总觉得机理上怎么也说不过去似的，呵呵。
   即便如此，我还是要重复一次个人看法：星月你向大家推荐美宝湿润烧伤膏，介绍你的个人使用经验，你没有错。甚至你的付出与辛苦值得感激。只是你做的有点过。
   我在自己的系列帖子里曾重点谈到过四力，其中便有“抗拒诱惑的定力”一说。我也一再表明我自己已经具备了这种定力。但是，人活在世上，不能光为了自己，是吧？
   故而，有此二帖。

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[此贴子已经被作者于2005-10-15 21:09:00编辑过]

<>很专业呀。冷月心炉是医生吧。

不好意思，冷月心炉，我没有太多时间向你讨教，但是，我现在只有用部分事实和相关报道来说话。你是医者，希望你以报道或者资料举出湿润烧伤膏不能用于大面积烧伤治疗的论证来，谢谢！至于脸部皮肤方面的应用，后一篇文章希望你好好研究一下，这是在我之前的应用实例！

附录：1996年就有资料报道银屑病进行期（红皮病型和脓包型）外搽湿润烧伤膏治疗，同时配合口服复方青黛丸、雷公藤片、克银丸等中成药，长波紫外线（UVA），温泉浴、海水浴，可以取得很好疗效。（见欧阳恒主编1996年版《实用皮肤病诊疗手册》296页）

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< 24pt?>湿润烧伤膏一药多用介绍

< 24pt?>· 临床经验诊疗介绍·

< 24pt?>烧伤湿润疗法自发明以来，得到了广泛的应用，湿润烧伤膏因其独特的剂型及药化在治疗皮肤创疡方面显示了良好的效果。现从其剂型及药化方面分析其在治疗不同疾病中的作用。

< 24pt?>湿润烧伤膏是一种框架结构的软膏剂，其主要成份是蜂蜡、黄柏、麻油，具有解毒、去腐生肌、活血化瘀作用：从生化分析，其中含有多种氨基酸、肪酸、糖类等营养成分及B一谷甾醇、黄芩甙、小檗碱等药物成分。由于以上成分的作用湿润烧伤膏可用于各种热力烧伤和电化学烧伤、各种皮肤溃疡(包括糖尿病性溃疡、外伤性溃疡、褥疮及静脉炎引起的溃疡等)、各部位的皮肤挫裂伤(特别是面部皮肤挫裂伤伴皮缺损)、宫颈糜烂、痔疮等肛肠疾病术后止痛等不难看出，湿润烧伤膏主要用于皮肤黏膜的病变。治疗以上疾病过程中，湿润烧伤膏起到以下作用：①抗感染：湿润烧伤膏与渗出物结合形成液化物，自行离开创面，为主动引流，降低致病茵毒性，并使创面产生一种纤维层， 对创面起保护作用。湿润烧伤膏利于细茵排出不利于其生长，故可有效预防感染。②加快创面愈合，防止疤痕形成：湿润烧伤膏本身具有活血化瘀、去腐生肌作用，其营养成分为上皮细胞的生长提供营养，并创造合理的生理环境，利于形成皮岛，利于损伤的毛细血管内皮细胞修复，减少血栓的形成，利于局部微循环的建立。③止痛：湿润烧伤膏使烧伤创面生态组织得以成活，痛觉感受器得到保护免受刺击，组织内产生的致痛物质如组织胺、缓激肽、5一HT前列腺素等减少，从而起止痛作用。

< 24pt?>在疾病治疗过程中，湿润烧伤膏可能只起到以上一种作用，也可能以上几种作用都表现出来。大家可以根据自己的经验把湿润烧伤膏应用到更多的领域，为广大患者去除病痛。

< 24pt?>作者单位：273200 山东省泅水县人民医院制剂科 (本文编校：刘渊)

<>【转贴】中国科学报 陈协川 1995年5月17日

1995年4月11日，美国专利局正式授予徐荣祥教授烧伤湿性医疗技术专利权，将我国这一无价的"财富"保护起来。这意味着美国政府对徐荣祥教授发明的烧伤湿性医疗技术的先进性、创造性给予法律承认。 在我国，国家科委于1989年将徐荣祥发明的烧伤技术列入国家级重大成果，并相继在全国推广。国家卫生部于1988年将其药品批准为国家级新药，并投入批量生产，保障了该新技术在全国的推广应用。1989年，卫生部又发出通知，为保障这项新技术更好地造福人民，决定以中国烧伤创疡科技中心为其技术指导部门，建立了全国烧伤新技术推广救治网。1991年，卫生部再次下发第63号文，将徐荣祥的烧伤新技术列入十年百项成果的首批十项重大医药技术向全国农村和基层推广普及。

1994年8月10日，全国烧伤湿性医疗技术大样本临床统计公告表明：我国每年用湿性医疗技术治疗住院烧伤病人（轻度未住院者未在统计之内）152869例，总治愈率达99.46％，治愈最大烧伤面积几乎近100％烧伤病人，深II度烧伤临床无疤痕愈合率达87.67％；解除了烧伤疼痛、烧伤创面感染等难题，并培训烧伤湿性医疗技术专业医师7698人。据统计，目前全国烧伤新技术医疗救治网医院共有4358家。1994年10月，特邀国际烧伤学会会员学术会议正式发布学术公告，确认了烧伤湿性医疗技术，使烧伤医疗学术又进入了一个新的烧伤组织学治疗阶段。

新的医疗技术及疗效

徐荣祥发明的烧伤湿润暴露疗法及与之配套的美宝烧伤膏，是实现烧伤湿性医疗技术的代表疗法和药物，而烧伤湿性医疗技术是针对烧伤组织治疗的代表技术，也是实现徐荣祥教授创立烧伤组织治疗技术的关键。虽然以往对该药及技术的报道很多，但由于保密及知识产权保护等原因，尚不能较具体报道其实质内容。正巧，记者在采访徐荣祥教授时，得知美国专利局于1995年4月11日正式授予徐荣祥的烧伤湿性医疗技术核心药品专利权。这是美国政府对徐荣祥教授发明的法律肯定。这不但标志着徐荣祥的医药技术水平领先于世界，而且用法律形式肯定了这一领域是我们中国人的发明创造，作为辉煌的一页永远记录在世界医学发展史上。

烧伤湿性医疗技术是一项作用较全面、操作较简单的医疗技术，正像美国新闻周刊的记者在考察了徐荣祥教授的烧伤治疗后报道中称的，只是用一片小板，将由植物油等组成的药膏涂在烧伤创面上，即可完成烧伤创面的全部治疗。应该说，科学水平越高，其操作使用越简单。但这一简单的过程，却凝聚着徐荣祥十几年来所付出的巨大代价，也凝聚着他的聪明智慧。他的烧伤湿润暴露疗法在烧伤创面发挥着五大作用：

1.保持创面湿润而不浸渍；2.由表入里液化排除坏死皮肤层；3.自动通畅引流；4.持续供药；5.隔离创面。这五大作用作为一种方法同时发挥作用，至今尚未见报道。而徐荣祥教授竟研究出一种新药，用药物剂型及有效成分来实现，则把技术溶于医药中，由药物在烧伤创面上自动发生作用。应该说，这更是一种奇迹。特别令人惊奇的是，这种美宝烧伤膏竟全是天然的、可作食品用的食用成分研制而成的。用一种营养性食品物质治疗世界难冶的烧伤，并一举获得成功，这并不是一般简单的组方或经验方法，或者是民间密方和一般药理知识所能实现的。在采访中，徐荣祥教授就技术药物的有机组成，从有机化学到生物化学，从物理基础理论到现代热能技术，从细胞分子生物学到基因重组技术等数十门学科的理论进行了阐述，使笔者感觉到医学发明创造太难了，绝非一日之功，绝非常人所能。如该技术中隔离创面的作用，一般理解为不就是把创面隔离开嘛！徐荣祥教授就对此问题谈了两个小时，还是简明扼要。他讲：隔离绝不是把创面放在一个不透气的塑料袋中或被厚的纱布包扎，而是要求能隔离一切外界刺激及组织内部积蓄刺激物质。也就是说，在没有皮肤的情况下，给烧伤创面制造一个皮肤所具有的功能，因为不具备皮肤功能的隔离对创面均有一定伤害或没有治疗作用的。

美宝烧伤膏自1988年投放医院以来，越来越受医生、病人的依赖。目前，它已被外国引用，同样在那里取得理想疗效。它是被外国政府确认的合法的中国药品。

徐荣祥的烧伤湿性医疗技术于1987年开始用于临床并在临床上获得了神奇的疗效，无论是在战场上还是在平时生活中发生的烧伤，均达到了使用方便、不需特殊条件、解除病人痛苦、避免残疾的疗效，从而深受医疗单位的欢迎。从要求经过特别训练的医生治疗烧伤转为广大烧伤医生都能治疗烧伤，并在临床上解决了烧伤治疗的国际四大难题：疼痛、创面感染、组织进行性坏死、深II度疤痕愈合。 这怎么能不受欢迎呢！特别是利用汗腺上皮再生表皮治愈深度烧伤近100％总面积的病人。前不久，在中铁建总医院收治的深度烧伤总面积86％、III度65％的一位病人，再次利用汗腺上皮再生表皮的技术治愈了该病人，重复了深度烧伤总面积近100％病人治疗的实践，取代了浅III度烧伤的手术植皮治疗方法。自烧伤湿性医疗技术问世以来，从国内到国外均获得很好的疗效。

1987年，在老山战斗后期，因战场条件所限，烧伤外科技术不能使用，是烧伤湿性医疗技术在一线战场上治疗救护发挥威力的机会，获得前所未有的战场疗效。特别是后期地雷炸伤伤员很多，解放军67医院成功地用于爆炸伤的医疗。

1988年1月，南沙战斗，南海舰队军医将烧伤湿性医疗技术用于海上救护，使烧伤伤员在高温、战火激烈的战舰上获得100％的治愈，并100％的未留任何疤痕，创下了世界烧伤史上的奇迹。

1990年5月19日，湖南新晃县境内一汽车发生爆炸，数十人严重烧伤，当地县医院用烧伤湿性医疗技术救治比较严重的11名伤员，结果除1例死于脑挫裂伤外，其余10名全部治愈未留残疾。

1994年12月，海口市酒店煤气发生爆炸事件，当地医院收治10例大面积烧伤病人，其中7例在中国烧伤中心的指导下使用烧伤湿性医疗技术救治，全部愈合。

1994年12在新疆克拉玛依市发生火灾，凡用烧伤湿性医疗技术治疗的病人全部康复。

在国外，1990年泰国煤气爆炸事件，采用湿性医疗技术治疗的各种程度烧伤均全部康复，未留残疾。

1992年在叙利亚，已全部改用我国的烧伤湿性医疗技术治疗。

在美国，现有较多病人也用我国的烧伤湿性医疗技术治疗，均自行愈合，未留残疾。

这里不一一列举。

1994年，全国大样本临床统计资料表明，中国烧伤创疡南阳科技医疗中心对烧伤总面积大于90％的烧伤病人治愈率达到92％，这与国际上烧伤外科技术的治愈率相比，有着非常明显的提高。

[此贴子已经被作者于2005-10-16 1:50:31编辑过]

<>痤疮（青春痘）是一种常见的皮肤上的皮脂腺毛囊感染，临床上可分为白头粉刺、黑头粉刺、红色丘疹、脓疮型和结节型几种类型。在青春期时,体内雄性激素分泌旺盛水平增高，使皮脂腺分泌增多，聚积于毛囊内不易排出，存在于毛囊内的痤疮丙酸杆菌在此条件下得以繁殖，并产生溶脂酶，分解皮脂中的三酸甘油脂，释放出游离脂肪酸，刺激毛囊引起炎症，进一步使毛囊壁受损而破裂，引起毛囊周围炎症形成痤疮。皮肤分泌旺盛和痤疮丙酸杆菌感染是痤疮形成的两大最主要因素。

<>[转帖]美宝烧伤膏对皮肤病疗效一例

<>http://club.women.sohu.com/read-face-1221455-0-489.html

<>主题：[原创]用美宝烧伤膏没效果的进来看——我的经验和总结的误区  
cat112@chinaren [cat112@chinaren] 发表于01-02 12:36 [发留言] [送礼物]  




我曾经不堪入目的豆豆脸现在好啦！！！只留一点点印子了，也在不断变浅！大家遇到得很多问题我也一一经历过，现在感觉是烧伤膏真的很不错的，只是可能由时候我们使用得方法不对影响了效果，所以想提醒大家注意一下。我可是不是托阿，我很早就注册了一直在潜水偶尔有发言，我对我说过的每一句话负责的。下面就说说我用的情况，呵呵不好意思我比较啰嗦，不喜欢看得可以直接去看我总结的用药的误区和注意事项（在第二楼），希望对大家有帮助。

    一、初用烧伤膏，消炎显著
先说说我的情况，我是典型的油性豆豆皮肤，长豆豆已经好几年了，来论坛最关心的就是治豆豆的帖子。青蛙那个帖子发的第一天我就看到了，而且马上去买了烧伤膏，但是因为之前用过很多各种各样的药了都没能治好，所以我也没有马上就用，过了几天，看大家都说一用就有效果，我就忍不住开始尝试了（好阴险啊……大家不要bs我拉，现在我不是回来报告了吗，咔咔）。用了两天，自己没觉得有多大变化，但是同学都说好了许多！（后来我分析可能是原来我的豆豆正在发炎往外鼓，用了药膏消炎了肤色也显得白净一些，所以外观感觉变化很大。）
    小结：发炎肿胀的豆豆用药初期效果明显

<>    二、用药发豆豆不消，我的对策
    接着就是持续的用，但好景不长，不几天满脸到处都有大或小的豆冒出来，我看青蛙的帖子说是正常现象，就坚持用，其实心里也很不好受，虽然原来就不堪入目，但无故添了新的豆豆，心里总归惴惴不安的。过了几天情况还是没有改善，我就急了，洗脸摸到凹凸不平的脸真难受啊，坚持了一个多星期也没有看到青蛙说的那种用药后脏东西往外排洗脸能洗下东西的情况。于是有一天我忍不住了，洗完脸就用青春棒清理，哇……清出好多黄色透明状油脂粒和白白的粉刺，受到这次成果的鼓舞，连着几天我都是洗完脸后趁毛孔还没闭合用青春棒清理，经过几天密集的清理，皮肤平整了许多。而且这种平整和没用药之前张豆豆自己清理感觉是不一样的，用药后的皮肤清理感觉能清的很彻底，应该是药膏让以前挤豆豆的残留和原有的豆豆长成熟了，能整个断根清理出来。（现在想想可能我的豆豆多数是闭合型的，成熟了也不能一洗就掉，所以用青春棒来辅助清理是很有好处的，要么这么等下去什么时候才能好啊。至于青蛙用得效果为什么那么好，我想又可能是因为他是男生的缘故，可能男生皮肤毛孔粗些？）
    小结：用药一段时间后新长的豆豆可以用外力清除，皮肤会变得平整。

<>    三、遗留印子的意外解决之道
    皮肤平整了但印子还在，看起来还是一脸大花，不过能恢复平整我已经很满意了，唉，可见长期的豆豆生涯已经让我产生了心理变态，只要稍微好一点我就谢天谢地。……我还是很虔诚的每天涂香油膏，盼望哪天洗脸印子刷刷掉下来。可是事实上我又坚持了一个多星期，脸上的印子还是依旧火红如故。这时候我又看到论坛上大家提到用药后皮肤会变干，于是我又开始加强补水，我用的是昭贵的芦荟鲜汁和芦荟胶，每次洗脸后拍上芦荟汁，然后涂上一层芦荟胶，之后再涂烧伤膏。这么干了几天，补水效果是有的，但对印子的作用还不大看的出来。而且我觉得这样用影响烧伤膏得效果，有芦荟汁和胶作用在先，烧伤膏就不能直接作用到皮肤里了，建议大家分开使用，即烧伤膏和芦荟汁分开使用，用了烧伤膏就不要用芦荟等产品，尽量让烧伤膏直接与清洁的皮肤接触。我的豆豆印子战争转折发生在我网购得竹炭皂到了之后。也是受论坛一个竹炭帖子的影响，一向关注豆豆的我一看竹炭皂对豆豆也有效果，马上蠢蠢欲动，在本地买不到，马上到淘宝淘了两块。还别说，竹炭皂洗脸效果绝佳，特别适合我这样的特油性皮肤，我用了它之后LG竹盐就丢到一边了。话说我第一次用竹炭皂，生平第一次感觉到了通透的感觉，一兴奋，连洗了三次，结果把皮洗破了（大家要是用到适合自己的产品可别象我这样得意忘形阿），意外的结果是把顽固的豆豆印子也洗掉一部分！我现在就是白天要出门就用芦荟汁和胶，在宿舍时候就用烧伤膏，淡化印子的效果真的不要太好了，要知道我有的印子可是有年头的都能去掉！
    小结：对付顽固豆豆印子，竹炭皂，芦荟汁和胶，烧伤膏一起上！非常重要的一点：不要把补水产品和烧伤膏混合在一起用，尽量分开使用。

<>  王者归来 精彩奥运尽在搜狐 进入奥运论坛

<>　主题：Re:  
cat112@chinaren [cat112@chinaren] 发表于01-02 12:38 [发留言] [送礼物]  




啰嗦了一大堆，只是想说明我是亲身体验过的，嘿嘿，下面是我的用法总结和一些建议：

<>1.用了一段时间的烧伤膏感觉没效果了呢？皮肤还和以前一样啊！
    注意看看豆豆是不是成熟了哟？有的闭合型豆豆看外表看不出来，洗脸后用青春棒一挤就出来一个大米……个人建议用药一段时间后可以对皮肤进行深层清理，有助于去除成熟油脂和角质。

<>2.脸部去角质、清洁工作非常重要
    青蛙的帖子也提到了去角质的重要性，烧伤膏是促使烧伤病人角质成长的，我们需要的是烧伤膏的渗入皮肤清理皮脂功能，所以要定期去除角质（我用竹炭皂洗脸过度把皮擦破就是歪打正着），个人推荐竹炭皂，真是非常好用！不过只限油性皮肤。

3.补水和用药不要一起（非常非常重要）
    冬天很多姐妹都觉得皮肤会干，也会用很多补水产品。补水很重要，但千万不要补水后再用药，应该尽量保证药膏与肌肤的直接接触。像我补水用得芦荟胶，本身就有隔离作用，涂防晒霜前上一层芦荟胶能增强防晒效果，但对要渗入皮肤的烧伤膏可是个严重阻碍。个人建议：补水工作和用药分开做，而且不要在用药前再往脸上涂任何的东西。

4.清淡饮食作用大
    我是个大馋猫，一顿无肉不欢。早就知道长豆豆不应该多吃油腻的东西，但我就是管不了自己的嘴（55，估计一辈子也改不了）。这次之所以能享受到清淡饮食的作用，是因为我的火锅搭档回家去了没人陪我腐败，我这几天吃的都很简单，有时候是馄饨，有时候是面包，因为牙龈发炎还每天喝大量的水，这里要废话以下，喝菊花茶真的很好噢，我的牙龈发炎就是喝好的（怕去医院要打针，我就每天喝菊花茶去火）。

    总之我现在皮肤恢复到了我每天都要美美照镜子的程度了，虽然还有些淡淡的印子，毛孔也有点大，但是我很有信心战胜他们哦！希望大家也能和我一样感受到惊喜！啊打了两个多小时呢，很辛苦的，如果有什么问题欢迎问我，我会不遗余力的解答！

[此贴子已经被作者于2005-10-15 23:49:43编辑过]

<>http://club.women.sohu.com/read-face-1103982-24-1829.html

<>主题：Re:Re:Re:Re:再也忍不住了,  
幸福要自己争取 [ashley_321@chinaren] 发表于12-05 09:00 [发留言] [送礼物]  

<>我脸上没痘痘了，只有初中时候长痘留下的好多小坑坑，8、9年了。用这个有效吗？
我想只晚上用，多久能好啊？

<>王者归来 精彩奥运尽在搜狐 进入奥运论坛

<>　主题：Re:Re:Re:Re:再也忍不住了,  
skintoner [skintoner@sohu] 发表于12-05 10:23 [发留言] [送礼物]  
  
我用了已经4天了,好像没看到什么效果呢?看大家说出来一些白头的东西,我也没有呀.有痘的地方也没有脱皮呀,也没有什么感觉.这个药膏是不是对我没有作用呀.现在虽然比刚开始的时候轻点了,但我认为是不是皮肤自行调节的有关系呀,因为皮肤要新陈代谢的嘛!而且我每次涂完第二天洗脸都要洗两遍,也没有像MM说的有光泽呀!
我说一下我的痘痘的特点:一是在下巴和嘴周围二是红色的疙瘩有点硬,没有白色的浓包.三按上去有点疼(不过现在已经好多了)四以前长痘留下来的红印,擦这个药膏后变成了突起,顶面有白头状的东东.五整个痘痘看上去像一个个红红的小点,非常有碍美观.目前就这些,请问楼主我该如何用药,以及这个药膏是否适合我?我是不是要坚持用药?谢谢!!急~~~~~~~~~~~

<>
　主题：Re:Re:Re:Re:再也忍不住了,  
半只青蛙℃ [jjpkok@sohu] 发表于12-05 10:24 [发留言] [送礼物]  

  
你的情况比较特殊!还是去医院磨皮吧!!

<>【在(幸福要自己争取)的大作中提到：】
>我脸上没痘痘了，只有初中时候长痘留下的好多小坑坑，8、9年了。用这个有效吗？
>我想只晚上用，多久能好啊？

<>　主题：Re:Re:Re:Re:再也忍不住了,  
半只青蛙℃ [jjpkok@sohu] 发表于12-05 10:34 [发留言] [送礼物]  


第一:你是"是在下巴和嘴周围二是红色的疙瘩有点硬,没有白色的浓包.三按上去有点疼(不过现在已经好多了)"说明里面的脏东西排出来了!!因为脏东西的量不太多,而且你这几个痘痘里的脏东西并没有密合成类似脂肪粒的东西,所以排除时不太明显,但确实是排出来了!你可以把痘痘处的药膏拿去医院化验!!

<>第二:"以前长痘留下来的红印,擦这个药膏后变成了突起,顶面有白头状的东东"这说明以前你的痘痘虽然表面上好了,只留下一些印子,但是里面的脏东西没有完全弄干净!!就好象一个活火山,随时会爆发!!而且毛孔里的脏东西不排干净,印子是消不下去的!!顶面的白色的东西就是引流出的脏东西,因为时间比较长了,你这几个毛孔里的油脂,脓什么的已经变成类似脂肪粒的东西,所以排出的时候比较明显,也就是你所说的"擦这个药膏后变成了突起,顶面有白头状的东东"!!

<>第三:"整个痘痘看上去像一个个红红的小点,非常有碍美观",因为药膏正在发生作用,把里面的东西往外拔,而且正在活血化淤,所以看起来痘痘有点突起而且有点发红!着是正常现象!!等排干净了就好了,而且不会流下印子!

第四:你所说的种种情况说名了药膏对你有用,你脸上的痘痘正在逐渐向好的方向发展!!如果你坚持认为这些情况都是对痘痘不利的,那可以停用!!

【在(skintoner)的大作中提到：】
>我用了已经4天了,好像没看到什么效果呢?看大家说出来一些白头的东西,我也没有呀.有痘的地方也没有脱皮呀,也没有什么感觉.这个药膏是不是对我没有作用呀.现在虽然比刚开始的时候轻点了,但我认为是不是皮肤自行调节的有关系呀,因为皮肤要新陈代谢的嘛!而且我每次涂完第二天洗脸都要洗两遍,也没有像MM说的有光泽呀!
>我说一下我的痘痘的特点:一是在下巴和嘴周围二是红色的疙瘩有点硬,没有白色的浓包.三按上去有点疼(不过现在已经好多了)四以前长痘留下来的红印,擦这个药膏后变成了突起,顶面有白头状的东东.五整个痘痘看上去像一个个红红的小点,非常有碍美观.目前就这些,请问楼主我该如何用药,以及这个药膏是否适合我?我是不是要坚持用药?谢谢!!急~~~~~~~~~~~

　主题：Re:Re:在也忍不住了,  
tiantian [merrywang1978@chinaren] 发表于12-05 10:41 [发留言] [送礼物]  


维A酸乳膏
我也用了，一点用都没有，5555555555

　主题：Re:Re:Re:Re:再也忍不住了,  
skintoner [skintoner@sohu] 发表于12-05 10:52 [发留言] [送礼物]  


楼主的话很专业呀,不过我想我还是会继续用的.有一个问题:现在脸上的痘痘颜色比以前红是不是正常现象?我知道中药用起来是比较慢,只要有效果,在一个月或两个星期内应该能看到效果吧?

　主题：Re:Re:Re:Re:再也忍不住了,  
83年的矿泉水 [bosane@sohu] 发表于12-05 11:01 [发留言] [送礼物]  

  
半只青蛙℃，向你和各位使用者汇报一下我的使用情况，最近，我的下巴上长了些红红的豆，一个星期了也没见好，昨天，看到你的贴子就买了药膏涂了一晚上，今天早上发现豆豆上面长白头了。也没有以前那么红了。我是否应试把白头挤掉，继续抹药呢

　主题：Re:Re:Re:Re:再也忍不住了,  
tiantian [merrywang1978@chinaren] 发表于12-05 11:21 [发留言] [送礼物]  
  
我今天去买烧伤膏试试看，希望有用！见鬼的豆豆害得我痛苦不堪！

　主题：Re:Re:在也忍不住了,  
半只青蛙℃ [jjpkok@sohu] 发表于12-05 11:29 [发留言] [送礼物]  


我也曾经用过维A酸乳膏,但是痘痘越用越多!
【在(tiantian)的大作中提到：】
>维A酸乳膏
>我也用了，一点用都没有，5555555555

　主题：Re:Re:Re:Re:Re:再也忍不住了,  
毛毛8291 [liqing8291@sohu] 发表于12-05 11:37 [发留言] [送礼物]  

樓主,一般的藥店都有賣嗎?我被痘痘折磨得不行了,下巴和額頭好多,而且有痘印.用過的朋友們,多貼一些心得哦!

　主题：Re:Re:Re:Re:Re:再也忍不住了,  
skintoner [skintoner@sohu] 发表于12-05 11:38 [发留言] [送礼物]  

半只青蛙我想问一下,你这个是多长时间好的?

　主题：Re:Re:Re:在也忍不住了,有痘有印的MM看过来,  
cat112@chinaren [cat112@chinaren] 发表于12-05 11:47 [发留言] [送礼物]  
  
555，吃火锅后长了两个豆！！！以后要少吃少吃少吃……
谢谢青蛙的忠告~！你真好人哈~！

【在(半只青蛙℃)的大作中提到：】
>嘿嘿!赶巧了,这个是专门为烧伤烫伤的人准备的!!你火锅少吃点哦,发痘痘的!而且现在火锅底料的卫生状况让人担忧!
>
>

[此贴子已经被作者于2005-10-15 23:51:06编辑过]

<>相关研究，仅供参考。举下列研究论文和例子，并不代表个人赞同或者否定态度，仅作为部分参考，本人非医务人员和医学研究者，所作工作仅为本人在医治本人爱人的过程中所理解和认识（有局限的）的部分依据。本人此观点和看法仅为本人自己所思所想，并不代表医学界的最终认定或可知的权威看法等等（因为本人不具备对医学研究的最终论断），本人过去所作之结论，均为个人之看法、意见，只能作为各位P友治疗银屑病的参考，如果本人在相关论断上有问题或者文理不通或者错误，请观者原谅并以审慎的态度来发表看法或者采取与本人方法相关的治疗手段、措施。如果患者不能确定美宝湿润烧伤膏的安全性或者认为不能安全的用于P病治疗或者烧伤治疗等等，那么，请勿采用本人提供之方法！！请仔细阅读上述文字！

<>本人声明：本人不负担因治疗方法、方式或体质因素等造成与本人治疗效果迥异的情况和与此可能相关的法律责任！谢谢！

<>http://www.etrs.org/bulletin11_1/section7.htm

<>

<>EUROPEAN TISSUE REPAIR SOCIETY NEWS FROM BEIRUT

< align=center>MOIST WOUND HEALING AND MOIST EXPOSED THERAPYrofessor Bishara S. Atiyeh and Dr Shady N. Hayek American University of Beirut Medical Center, Beirut, Lebanon <>Introduction Wound healing is a complex and highly regulated process that can be compromized by both endogenous and exogenous factors.1 In both primary and secondary healing it consists of a series of events characterized by inflammation, epithelialization, connective tissue deposition and contraction. The contribution of each event varies according to the type of wound.2 At any rate, the longer it takes for spontaneous wound healing to be completed, the worse the outcome usually is, with increasing likelihood of developing hypertrophic scarring and unsightly alterations in pigmentation. Moreover, under unfavorable conditions, the self-perpetuating inflammatory cascade may result in increasing tissue destruction and necrosis rather than healing.3,4 On the other hand, understanding the concept of occlusion has been fundamental to the evolution of our knowledge about wound healing leading to the development of new wound dressings and has created a paradigm shift in the management of wounds.6,7,8,9,10 Before this understanding, wounds often were kept dry, as advocated by Pasteur to keep them ‘germfree‘.6 There is now growing evidence of improved healing of full- and partial-thickness cutaneous wounds in wet and moist environments. Retention of biologic fluids over the wound prevents desiccation of denuded dermis or deeper tissues and allows faster and unimpeded migration of keratinocytes over the wound surface. It allows also the naturally occurring cytokines and growth factors to exert their beneficial effect on wound contracture and re-epithelialization. Enthusiasm generated by these results has been, however, tempered by concerns over tissue maceration and infection following prolonged cutaneous water exposure.2,11 These concerns may not be justified.2,12,13 Nevertheless, despite mounting evidence and appreciation of the biologic beneficial factors of moist environments, applying the moist healing principles to large surface areas, in particular to large burns and skin graft donor sites, is hindered by the major impracticality and technical handicap of creating and maintaining a sealed moist environment over these areas.5,14,15 Dressings have been used since antiquity to facilitate the healing process. More recently many sophisticated dressings have become available to the wound care practitioner. These newer materials and agents supplement older dressing materials, such as gauze, which still are commonly used.6 Wound dressings provide several important functions including protection, prevention of infection, promotion of healing through keeping the wound moist and warm, reduction of pain, absorption of exudate, comfort, stability and reduction of wound motion. Dressings should also be easy to apply and remove without causing further trauma. Although there is not one ideal dressing capable of providing all these functions, and not every wound requires every attribute, yet a wound may need a different dressing as it progresses through the healing process.6,7,8 Different dressing materials, devices and agents provide different functions to greater or lesser degrees, and the attributes of each need to be matched to the specific wound on which it is placed.6 <>Moist Exposed Burn Ointment Since recent evidence suggests that moist environment favors more optimal healing, and since currently available moisture retentive devices cannot be universally applied, clinical trials were conducted to evaluate the efficacy of a newly introduced moisture retentive ointment, MEBO (Moist Exposed Burn Ointment) (Julphar Gulf Pharmaceutical Industries, UAE), on primary healing of surgically repaired wounds and on re-epithelialization of partial thickness wounds. The ointment is capable of providing an optimal moist environment without the need of an overlying occlusive dressing. MEBO is a Chinese burn ointment with a USA patented formulation since 1995. The active component of the ointment is b-sitosterol in a base of beeswax, sesame oil and other components. Clinical and experimental studies reported in the Chinese literature have demonstrated that it reduces markedly evaporation from the wound surface.15 Though MEBO does not have any demonstrable in vitro bacteriostatic and bactericidal activity probably due to its oily composition that does not allow proper diffusion in a watery culture medium,16,17, 26,27 it has been shown that in vivo, it had similar action to 1% Silver Sulfadiazine in controlling burn wound sepsis and systemic infection with P. aeroginosa.18,28 It has also been demonstrated experimentally that MEBO exhibited a statistically significant wound healing potential on rabbit corneal epithelium as compared to saline, homologous serum, Vitamin A and dexamethasone.19 The ointment produces good analgesia and has a good debriding effect, moreover, it drastically reduces water loss and exudation from the open wound surface. The required frequent application of the ointment is easy and can be performed by the patient himself or a member of his family. The most remarkable practical advantage of MEBO over other types of dressings is that it provides an effective wet environment favorable for optimal wound healing without the need of any covering or occlusive dressing. In some cases, however, particularly when the patient is not confined in bed or at home, a simple covering dressing may be more convenient.

[此贴子已经被作者于2005-10-16 14:12:22编辑过]

Moist exposed burn ointment (MEBO) has been used traditionally in China for topical burn injuries treatment and was explored by Xu Rongxiang20 from the Beijing Chinese Burn Center. It has been popularized outside China only two and a half decades ago. Reports about its properties and functions have been published in the Chinese literature; there was, however, a need to independently document the claimed benefits of this ointment in wound healing. Chinese traditional medicine (CTM) is quite different from the type of medicine and approach to disease as practiced in the west. Amongst our frenetic drive to develop more and more sophisticated and active wound healing devices and treatment modalities, it is wrong, however, to totally disregard CTM and its empirically time proven practices and remedies. It is difficult though to accept CTM without somehow adapting it to our ways of scientific analysis and documentation.21 < align=center>Figure I: (A) Healed STSG donor site at 2.5 months.
Note better cosmetic result of the area treated with moist exposed burn ointment (MEBO®).
Note also epidermal sliding present in the area treated by Sofra-Tulle ®.
Demarcation zone between the two treatment areas indicated by arrow.
(B and C) STSG donor sites treated by MEBO® and Tegaderm®.
Better healing with better cosmetic result observed with MEBO®.

< align=left>Clinical Trials

We as well as others have already validated the claim that the ointment effectively preserves moisture at the surface of partial thickness wounds by both experimental studies and clinical trials. Results have already been published documenting better re-epithelialization.21,22,23,24,25,26,27,28 When compared to the classical split thickness skin graft donor site dressing consisting of an antibiotic impregnated Vaseline gauze (Sofra Tulle®, Roussel Laboratories Ltd., Uxbridge, England) covered by a bulky gauze dressing, moist exposed burn ointment promoted speedy healing with excellent cosmetic outcome.23,24,25 Re-epithelialization of donor sites with ointment application was also better than dressing the donor sites with Tegaderm® (3M Health Care, St Paul, MN), a moisture retaining semi-permeable adhesive film27,28 (Figure 1). MEBO treatment resulted in earlier anatomical healing with significantly superior cosmetic appearance of the resultant scars over six months follow-up. The study demonstrated also significantly faster functional healing with restoration of cutaneous barrier function with ointment application. The observed positive correlation between improved scar quality and early physiologic recovery indicated that better cosmesis and improved function are closely linked.
When evaluating primary healing using the visual analogue scale,29 cosmetically better scars consistent with lower scores are observed following prophylactic MEBO application for a period of six weeks after wound primary suturing at one, three, and six months when compared to a control no treatment group and another group treated with topical antibiotic application (Fucidin®, Leo Pharmaceutical, Danmark)30,31 (Figure 2). Though significant differences in scores for colour, contour, distortion, and aspect between the three groups were observed with more favorable scores for the MEBO treated group, only colour scores exhibited significant changes over time. At six months, the observed colour difference among the three groups becomes nonsignificant. It is, however, extremely significant at one and three months indicating that the permanent scar colour may be expected at an earlier stage whenever the scar is managed prophylactically with MEBO. Of all the parameters, only differences in texture values reflecting deeper dermal healing became extremely significant at six months while these were less significant at one and three months, indicating a net divergence in fibroblastic and scar remodeling activity between the treatment groups in favor of moist exposed burn ointment.

< align=center>Figure 2: Improved scar quality of primarily
healed facial lacerations.

<>Conclusion

Our investigation of this new moisture retentive ointment indicates so far that it has a definite positive effect on wound healing. The nature of the studies and their limited clinical scope, allow us, however, only to speculate on its mechanism of action as well as on its effect on the various phases and components of the wound healing cascade. Further research is still required to explore the bio-cellular mechanisms involved and its action on the different cytokines and metalloproteinases proven lately to be essential in determining the final outcome of healing. These reported studies as well as another prospective clinical trial of this ointment in topical treatment of chronic ulcers32,33 have demonstrated the extreme ease of application and practicality of this ointment in providing the necessary moist conditions for optimal healing as compared to currently available labor intensive and time consuming moisture retaining products and devices. Though it is not an antibiotic and definitely not suitable for the treatment of established wound sepsis, adequate local antibacterial action of the ointment maintaining open wounds in a healthy ‘none infected’ condition has also been demonstrated. Even when used for prolonged periods of time, emergence of resistant strains was not observed.32,33

<>References 1. Bowler PG. Wound pathophysiology, infection and therapeutic options. Ann Med 2002; 34: 419–427. 2. Grinnel F. Fibroblasts, myofibroblasts, and wound contraction. J Cell Biol 1994; 124: 40–44. 3. Grossman PH, Grossman AR. Treatment of thermal injuries from CO2 laser resurfacing. Plast Reconstr Surg 2002; 109: 1435–42. 4. Spence RJ, Wong L. The enhancement of wound healing with human skin allograft. Surg Clin North Am 1977; 77: 731–745. 5. Atiyeh BS, El-Musa KA, Dham R. Scar quality and physiologic barrier function restoration after moist and moist-exposed dressings of partial-thickness wounds. Dermatol Surg 2003; 29: 14–20. 6. Lionelli GT, Lawrence WT. Wound dressings. Surg Clin North Am 2003; 83: 617–38. 7. Thomas DR, Kamel HK. Subacute care for seniors, Clin Geriat Med 2000; 16: 783–804. 8. Pearson AS, Wolford RW. Management of skin trauma. Dermatology 2000; 27: 475–92. 9. Mostow EN. Wound healing: A multidisciplinary approach for dermatologists. Dermatol Clin 2003; 21: 371–387. 10. Brem H, Nierman D, Nelson JE. Pressure ulcers in the chronically critically ill patient. Critical Care Clin 2002; 18: 683–694. 11. Winter GD. In: Epidermal regeneration studied in the domestic pig. Maibach HI, Rovee DT (eds). Epidermal wound healing. Year Book Medical Publishers, Inc. Chicago 1972, 71–112. 12. Vogt PM, Andree C, Breuing K, Liu PY, et al. Dry, moist, and wet skin wound repair. Ann Plast Surg 1995; 34: 493–499. 13. Reuterving CO, Agren MS, Soderberg TA, Tengrup I, et al. The effects of occlusive dressings on inflammation and granulation tissue formation in excised wounds in rats. Scand J Plast Reconstr Surg 1989; 23: 89–96. 14. Jonkman MF, Hoeksma EA, Nieuwenhuis P. Accelerated epithelialization under a highly vapor-permeable wound dressing is associated with increased precipitation of fibrin(ogen) and fibronectin. J Invest Dermatology 1990; 94: 478–84. 15. Wang GS, Zhang YM, Liu RS, et al.: Experimental study of the Effect of MEBO on blood rheology in the treatmet of burned rabbits. Chinese J Burns Wounds Surf Ulcers 1993; 5 (4): 30–32. 16. Qu YY, Wang YP, Qiu SC et al.: Experimental research on the anti-infective mechanism of MEBO. Chinese J Burns Wounds Surf Ulcers 1996; 8 (1): 19–23. 17. Xing D: Experimental study on the actions of the moist burn ointment on promoting healing of skin wound and anti-infection. Chinese J Burns Wounds Surf Ulcers 1989; 1 (1): 75–76. 18. Geng XL, Bu XC, Gao FQ, Liu YL: Study on the bacterial count in the subeschar living tissues of burn wounds. Chinese J Burns Wounds Surf Ulcers 1989; 1 (1): 49–50. 19. Huang QS, Zhou G, Su BP, Huang EX: A comparative study of fibronectin and MEBO in the treatment of experimental rabbit corneal alkaline burn. Chinese J Burns Wounds Surf Ulcers 1995; 7 (1): 18–9 20. Xu R: the medicine of burns and ulcers, a general introduction. Chinese J Burns Wounds Surf Ulcers 1989; 1 (1): 68 21. Atiyeh BS, Ioannovich J, Magliacani G, Masellis M, Costagliola M, Dham R, Al-Musa K A. A new approach to local burn wound care: moist exposed therapy, a multi-phase, multicenter study. J Burns & Surg Wound Care [serial online] 2003; 2:18. Available from: URL: http://www.journalofburns.com 22. Ioannovich J, Tsati E, Tsoutsos D, Frangia K, et al. Moist exposed burn therapy: evaluation of the epithelial repair process (an experimental model). Ann Burns Fire Disast 2000; 8: 3–9. 23. Atiyeh BS, Ioannovich J, Al-Amm CA. Pansements de sites donneurs de greffe de peau mince: resultats preliminaires d’une etude clinique limitee comparative de ‘MEBO’ et de ‘sofra-tulle’. Brûlures, Revue Française de Brûlologie 2000; 1: 155–61. 24. Atiyeh BS, Ghanimeh G, Kaddoura IL, Al Amm C, Ioannovich J. Split thickness skin graft donor site dressing: preliminary results of controlled clinical comparative study of MEBO and sofra-tulle. Letter-to-the-editor. Ann Plast Surg 2001; 46: 88–89. 25. Atiyeh BS, Al-Amm CA, Nasser AA. Improved healing of split thickness skin graft donor sites. J Applied Research 2002; 2: 114–21. 26. Ang ES, Lee ST, Gan CS, See P, et al.: The role of alternative therapy in the management of partial thickness burns of the face – experience with the use of moist exposed burn ointment (MEBO) compared with silver sulphadiazine. Ann Acad Med Singapore 2000; 29: 7–10. 27. Atiyeh BS, Al-Amm CA, El-Musa KA, Sawwaf A, Dham R. Scar quality and physiologic barrier function restoration following moist and moist exposed dressings of partial thickness wounds. Dematol Surg 2003; 29: 14–20 28. Atiyeh BS, Al-Amm CA, El-Musa KA, Sawwaf A, Dham R. The effect of moist and moist exposed dressings on healing and barrier function restoration of partial thickness wounds. Eur J Plast Surg 2003: 26: 5–11. 29. Beausang, E, Floyd, H, Dunn, KW, Orton, GI et al. A new quantitative scale for clinical scar assessment. Plast Reconstr Surg 1998; 102: 1954–61. 30. Atiyeh, BS, Ioannovich, J, Al-Amm, CA, El-Musa, KA, Dham, R. Improving scar quality: A prospective clinical study. Aesth Plast Surg. 2002; 26: 470–6. 31. Atiyeh BS, Amm CA, El Musa KA. Improved scar quality following primary and secondary healing of cutaneous wounds. Aesth Plast Surg 2003; 27: (in press). 32. Atiyeh BS, Ioannovich J, Magliacani G, Masellis M, Costagliola M, Dham R. The efficacy of moisture retentive ointment in the mangement of cutaneous wounds and ulcers: a multicenter clinical trial. Indian J of Plast Surg 2003; 36: 89–98. 33. Atiyeh BS, Ioannovich J, Magliacani G, Masellis M, Costagliola M, Dham R. The efficacy of MEBO (moist exposed burn ointment) in the management of cutaneous wounds and ulcers: a pilot study. Letter-to-the-editor, Ann Plast Surg 2002; 48: 226–7. <>Bishara S. Atiyeh, MD, FACS Clinical Professor Division Plastic and Reconstructive Surgery American University of Beirut Medical Center Beirut, LEBANON <>Shady N. Hayek, MD Chief Resident Division Plastic and Reconstructive Surgery American University of Beirut Medical Center Beirut, LEBANON <>Responsible Author and Reprint Requests: Bishara S. Atiyeh, MD, FACS. Clinical Professor Division of Plastic and Reconstructive Surgery American University of Beirut Beirut, Lebanon Tel: (916) 3 340032 Fax: (961) 1 363291 E-mail: aata@terra.net.lb
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Recent Burn Treatment Research

1) A new dressing helps treat graft donor sites on burn patients.

<>Temporary dressings are used for a variety of reasons on serious burn wounds. One new product is called OrCel and uses layers of human skin cells (from someone other the donor) and collagen (a tough connective tissue) from cows to make a dressing that can be applied to a burn wound or donor graft site for two to three weeks and then removed. A study compared the effectiveness of OrCel with a product that has been in use for decades and is composed of layers of silicone, nylon, and collagen from pigs. The researchers concluded that partial thickness donor sites healed more quickly with OrCel dressings than with the standard product. One advantage of early healing is that a donor site can potentially be reused for another graft after the area heals. Burns. 2003 Dec; 29(8): 837-41.

2) Moist exposed burn ointment may reduce hypertrophic scarring.

<>Researchers investigating hypertrophic scars (scars that grow above or outside the wound) have been limited because animals do not form hypertrophic scars. As a result, experiments using animals rather than people are not helpful in developing new treatments for people (regardless of one’s beliefs about animal experimentation). Researchers in Lebanon evaluated whether different types of wound dressings may help prevent hypertrophic scarring. The wounds that were treated were either donor sites for partial thickness skin grafts or wounds that were allowed to heal without grafting or surgical closure. The researchers concluded that patients treated with moist exposed burn ointment (MEBO) had less hypertrophic scarring than patients treated with dressings, Tegaderm, or antibiotic ointment. Aesthetic Plastic Surgery. 2003 Dec 4.

3) Full thickness skin grafts are helpful in treating burn wounds on the face.

<>Because of the cosmetic importance of skin on the face, facial burns are a particular challenge. For 15 to 20 years the study researchers followed 18 patients who had received full thickness skin grafts for facial burns. The grafted skin was able to sweat, had oil glands, and was elastic. Partial thickness grafts don’t have sweat or sebaceous (oil) glands. When looked at under a microscope, the grafted skin looked more like regular facial skin than skin from the area of the donor site. The researchers suggested that full thickness grafts for facial burns may produce the best results. Zhonghua Zheng Xing Wai Ke Za Zhi. 2003 Jul; 19(4): 276-8.

4) A new product helps in the healing of burn wounds on the hand.

<>French researchers studied the use of a product called Integra Dermal Regeneration Template for deep hand burns. Integra was used to cover the wounds either immediately after hospitalization or later during reconstructive surgery. Integra has two layers: 1) a permanent bottom collagen layer (from cows) that is a substitute for the dermal layer of the skin (the layer beneath the epidermis, which is the top layer of the skin); and 2) a top silicone layer that is a temporary substitute for normal epidermal skin. Two to three weeks after the wound is covered with Integra, the silicone layer is removed and replaced with a very thin donor graft of epidermal skin. Using thin epidermal skin grafts instead of thicker split thickness grafts has two potential advantages. The donor site looks more like normal skin after it has healed because there is less scarring when a thinner graft is removed. The donor site also heals much more quickly and can thus be “re-harvested” more quickly for additional grafts. The layer of collagen is left in place as a substitute dermal layer of skin and supports the donor epidermal graft (hence the name “regeneration template”).The researchers found that Integra worked well. There was a 100% “take” of the grafts and the grafted skin was flexible and supple enough to allow easy use of the joints in the fingers and hands. The cosmetic result was judged to be satisfactory. British Journal of Plastic Surgery. 2003 Dec; 56(8): 764-74.

5) A new dressing for second degree wounds helps prevent infection.

<>A new dressing product is being investigated in France. It has been tested on patients with second degree wounds. None of the patients developed infections and for those patients who had grafts, all of the grafts “took.” The product saturates a new type of dressing (lipidocolloid) with sulfasalazine, which has long been used in burn units to prevent infections. J Wound Care. 2004 Apr; 13(4): 145-8.

6) Tissue expanders are helping in the treatment of some pediatric burn patients.

<>One way of growing additional skin is with tissue “expanders.” A surgeon (usually a plastic surgeon) places a balloon under the skin and then gradually inflates the balloon with salt water. As the balloon gets bigger, the skin covering the balloon expands by growing new skin. After the skin expands, a “flap” of the expanded skin is used to cover a nearby area of skin that needs to be replaced. There are several advantages of tissue expansion. First, the expanded skin will be a good match in terms of color, texture, thickness, and the amount of hair. This is particularly important in areas such as the scalp and face. Second, because the skin doesn’t need to be moved, there is usually less visible scarring. Third, the blood supply for the skin flap remains intact and so the likelihood that the flap will take is higher than when skin is moved from a graft site. Fourth, the nerve supply in the flap is not cut and so the person will have feeling in the flap. The disadvantages of tissue expanders include the time it takes to expand the skin (up to three or four months); the unsightly bulge that occurs as the balloon is inflated; the possibility that the expander will rupture and require additional surgery; and the possibility of infection in the area of the expander. The article discusses the use of tissue expanders in children, including burn survivors. Because of the time tissue expansion requires, use in burn patients is limited to reconstructing scarred areas with healthy nearby skin. J Craniofac Surg. 2003 Nov; 14(6): 866-72.

7) Exercise is important in preventing contractures.

<>A “contracture” is a shortening or shrinking of tissue. Grafted skin and scars shrink. When shrinkage occurs near joints and other moving body parts, such as the fingers and the eyelids, it can make movement much more difficult. Contractures can also occur when a part of the body isn’t used normally. For example, burn survivors who must keep a limb in a particular position to allow for healing of a graft or wound may experience shortening of the tendons or ligaments in that limb. When tendons and ligaments shorten, normal range of motion in the limb is lost. Such contractures may have to be “released” surgically. Exercise is one important way to prevent contractures. The author reports on the exercises used by a patient who had developed contractures requiring surgery to regain flexibility and prevent contractures from recurring following the surgery. J Burn Care Rehabil. 2003 Nov-Dec; 24(6): 378-81.

8) Thymus oil may be helpful in burn wound healing.

<>When burns occur there are very complicated responses by the body, some of which are poorly understood. One chemical produced by the body in larger amounts than normal following a burn injury is nitrous oxide, which can potentially cause further damage to wounded tissues. One hypothesis is that increased nitrous oxide may reduce blood supply to injured tissue by increasing the tendency of blood to clot. Researchers have investigated whether naturally occurring substances may help with wound healing. One such substance is thymus oil, which is known to have antiseptic and antioxidant properties. It was found that thymus oil decreased the levels of nitrous oxide in burn patients and promoted the formation of new skin. J Burn Care Rehabil. 2003 Nov-Dec; 24(6): 395-9.

9) Light therapy may help diabetic burn survivors.

<>Wound healing is usually a much bigger problem for people with diabetes than for people who don’t have diabetes. Diabetes affects blood vessels and can reduce the blood supply to the body’s tissues. Because blood transports oxygen, nutrients, and cells that are important for wound healing, a reduction in blood supply slows healing, including healing of burns. Researchers in Saudi Arabia performed experiments to determine whether a particular type of light (polychromatic light emitting diodes (LED)) stimulated healing of burn wounds in diabetic rats and nondiabetic rats. They concluded that LED light encouraged wound healing for the diabetic rats but not for rats without diabetes. Journal of Clinical Laser Medicine and Surgery. 2003 Oct; 21(5): 249-58.

10) Why don’t cultured epithelial autografts always take?

<>Swiss researchers are investigating why cultured epithelial autografts (CEA’s) don’t always “take.” A CEA is produced by removing living, unburned skin cells from a burn patient and using those cells to grow thin sheets of new cells in a laboratory. A CEA is then grafted back onto the burn patient. There are two major advantages of CEA’s. First, “autografts” (grafts from the patient’s own skin) are not limited to areas of the patient’s unburned skin. New “skin” can be grown. This is particularly important for patients with extensive burns. Second, the grafts are not rejected by the patient’s immune system because the grafts are “recognized” by the immune system as being part of the person’s own body. One problem with the grafts has been that, on average, about 35% of CEA’s don’t end up taking; i.e., they don’t bond with the tissue beneath the graft. The Swiss researchers focused on the percentage of the cells in a CEA that continue to live following the grafting procedure. They found that more than 90% of the cells survived, leading them to conclude that early death of the cultured cells is not a good explanation for the failure of a CEA to take. The researchers did find that other biological processes occurring in cells varied a great deal between individuals and might explain why CEA’s take in some patients and not in others. International Journal of Artificial Organs. 2003 Sep; 26(9): 793-803.

11) Porcine wound models for skin substitution and burn treatment.

Skin regeneration is an important field of tissue engineering. Especially in larger burns and chronic wounds, present treatments are insufficient in preventing scar formation and promoting healing. Initial screening of potentially interesting products for skin substitution is usually done by in vitro tests. Before entering the clinic, however, in vivo studies in immunocompetent animals are necessary to prove efficacy and provide information on safety aspects.

We have obtained extensive experience using the domestic pig as test animal for studies on skin replacement materials, including tissue engineered skin substitutes, and burn wound treatment.

Two models are described: an excisional wound model for testing of dermal and epidermal substitutes and a burn wound model for contact and scald burns, which allows testing of modern wound dressings in comparison to the present gold standards in burn treatment. The results of these experiments show that in vivo testing was able to reveal (dis)advantages of the treatments which were not detected during in vitro studies.
Biomaterials. 2004 April Pages 1559-1567

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Bacterial cellulose retains water and promotes ''moist'' healing

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<>Figures below

<>

<>Fig. 1: Secondary healing of STSG donor site with MEBO, Sofra-Tulle, and Tegaderm. Better quality scar is observed with MEBO

<>

<>Fig. 2: Primarily healed scar over face treated prophylactically with MEBO. Rapid scar maturation is observed with good scar quality.


<><>

<>Fig. 3: Secondary healing of wound dehiscence with MEBO. Rapid progression of Healing
Index