The Chinese Journal of Burns Wounds and Surface Ulcers 2003, 15(4): 351-354

Progress in the Application of MEBO in Clinical Surgery

Liu Yingxiang, He Renliang
Huangpu People' s Hospital, Zhongshan City, Guangdong Province 528429
[Abstract] Objective: To make a review of the progress in the application of MEBO in
clinical surgery. Method: A literature survey was made and the data analyzed.
Result: MEBO as a core in MEBT has not only been widely used in burn treatment and
has very good efficacy but also widely used in surgical and other medical fields.
Conclusion: MEBO has very good prospects in its application in clinical surgery.
[Key Words] MEBO; Surgical wound and ulcer; Clinical application; Efficacy analysis
[CLC number] R64
[Document code] A
[Article ID] 1001-0726(2003)04 -0351-04
As the key drug of MEBT, MEBO has been used all over China for more than 10 years,
since MEBT was put forward by Professor Xu RX based on the traditional Chinese medical
theory and modern theory of burn pathology and physiology in the middle 1980s. It has
been proved by many years' clinical application and experimental study that several
difficulties such as burn infection, assuaging pain and scar proliferation were solved
perfectly [1]. With the extensive use of MEBO in clinical practice, the application field of
MEBO in surgery will surely be enlarged. The following is the review and summary of the
application and development of MEBO in clinical surgical practice in recent years:
A. Bedsore Ulcers (Phase bedsore)
Bedsore ulcers, which are common in patients with debility, paralysis and long-term lay-up,
refer to the tissue necrosis and ulceration due to long-term pressure on skin blood vessels
and nerves, which damages local blood circulation and results in nutritional disturbance.
The key points in decubital treatment are as follows: treat the primary disease actively,
strengthen the basic nurse, enhance the resistance of the body, control wound infection,
keep wound drained unobstructedly, ameliorate local microcirculation, and accelerate
tissue regeneration and restoration [2]. Li SL [3] used exposed and binding-up therapies to
treat 15 cases of bedsore ulcers with different depth and course in different parts with
MEBO. All the patients were healed without toxicity and side reactions. Zhang SC etc.
[4]
immerged the antiseptic gauzes into warmed MEBO to make MEBO gauzes, and
covered the bedsore wound or filled sinus tracts. The drug and dressing were changed
once or twice a day. All the 5 cases were healed. Chen ZY etc. [5] used MEBO to treat
32 cases of bedsore ulcer, and observed the changes in wound, the bacterial culture
results of wound, and scars after the wounds were healed. They thought MEBO had
strong anti-infection capacity, and could improve local microcirculation, reduce scar
formation, and had no influence on the functional restoration of the functional parts. Kong
Jun [6] treated 60 cases of bedsore ulcers due to different causal factors in different parts
with bandaging therapy. The cure rate after 2 months was 78.3%, and the cure rate after
6 months reached 96.7%.
B. Contused and Abrased Wound of Skin Soft Tissues

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The Chinese Journal of Burns Wounds and Surface Ulcers 2003, 15(4): 351-354

Acute wounds with skin soft tissues contused and abrased are acute skin injuries due to
the composite forces in trauma, which are the complication of abrased wound and
contused wound, and belong to skin ulcers [7]. Although acute wound with skin soft
tissues contused and abrased is not severe in clinical practice, but its incidence is high,
and the wound is in the exposed place with severe pollution. Traditionally, astringent for
external application is used to obtain subcrustal healing. Although the wound turns dry
fast, subcrustal infection often comes into existence. The incidence of scar is high,
resulting in dysfunction, ugly appearance, and bad life quality. It is believed in modern
wound restoration standpoints that wetness is in favor of wound healing [8]. When
treating the open wounds, traditional dry binding therapy can lead to superficial necrosis,
impede the regeneration of epithelia, therefore moist therapy is better [9]. He RL [10], Liu
WG etc. [11] treated 39 and 96 cases of skin wound with soft tissues contused and abrased
respectively. Phase healing was acquired for all the patients, and the healing time
was 7-30 days. Based on the comparative study between MEBO therapy and high
efficiency iodine therapy in the healing mode of wound, healing time, local therapeutic
reactions, analgesic effects, scar incidence at 3 months, toxicity and side effects when
treating acute skin soft tissue contused and abrased wound, He RL etc. [12] came to a
conclusion: MEBO therapy was better with fast analgesia, good curative effects, fewer
pains during dressing change, strong anti-infection effects, short healing time, alleviated
scar healing, little pigmentation in the healed wound, few toxic and side effects, and better
patient toleration. Meng Xia etc. [13] treated 23 case of maxillofacial soft tissue abrasion.
All the wounds were healed with first intension without infection, pigmentation and
apparent scar. Sai FD etc. [14] treated 10 severe extremity and joint skin abrasion patients
with MEBO. The treatment course was 7-15 days. All the wounds were healed without
infection, scar or dysfunction, and the damaged joints returned to normal.
C. Skin Soft Tissue Impairment
Skin soft tissue impairments can result from both congenital and acquired causes.
Congenital causes are concerned with intrauterine infection of the fetus; the acquired
cause is related to traumas and local infection. In the past, operation therapy was taken
to treat these diseases, but its expense was high, and it was difficult to be accepted by
patients and their relatives. Zhao Xiong etc. [15] treated 8 cases of new-born congenital
skin defect with 1%-15% defect area. Defect parts: 5 lower extremity defect cases, 2
upper extremity defect cases, and 1 trunk defect case. The average healing time was
7-21 days. There was no infection, necrosis or scar, and the skin had good elasticity.
The author thought MEBO was an ideal drug for treating congenital skin defects. Zhang
HZ etc. [16] treated 19 cases of finger tip defects due to traumas with MEBO. All the
patients were healed without apparent infection. The shortness of affected fingers was
not obvious after they were healed, there was no obvious dysfunction, and the unbroken
nails in the nail bed were reproducible. Qu YB etc. [17] compared MEBO therapy with
routine surgical dressing change method in treating infected small-area scalp defects after
traumas with the results as follows: the healing time was shorter with MEBO therapy, and
local pains and hemorrhage etc. were avoided. Su YT etc. [18] cured 5 cases of
small-area exposed bone with MEBO bandage, and 6 cases of large-area exposed bone
with MEBO bandage, bone cortex drilling and skin grafting. Wei JG etc. [19] treated 40
cases of large-area avulsion injury wound with skin flap necrosis after debridement and

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stitching in original position with MEBO treatment in the whole treatment process. All the
wounds were healed physiologically. The skin had good elasticity and normal color
without cicatricial contracture sotomy, ankylosis, infection, or sepsis. Among the 40
cases, 30 cases had open fracture, and the wound with maximal area is 32 cm 13 cm.
D. Fissure of Nipple
Fissure of nipple often takes place in primipara due to depressed nipples, short nipples,
lack of lactation, improper lactation posture. The skin was impaired and fissure of nipple
appeared because of sucking. The clinical manifestation is as follows: there are
epidermal desquamation, skin rupture at the root of nipples, and ulcers around nipples; the
pains are aggravated during lactation; some patients even had suppurative mastitis. The
curative effects of the past therapies were not satisfying, and these therapies interfered
with lactation and aggravated the inadequate drainage of breast milk. Li XA etc. [20]
treated 260 cases of nipple fissure patients with MEBO, and all the patients were cured in
3-12 days.
E. Abscess Drainage
Abscess is the accumulation of pus in the tissues, organs or body cavities with an intact
wall in the acute inflammation of deep tissues. The treatment includes antibiotics for
systemic or local use, local hot application, physical therapy, incision and drainage through
operation, and the drain after operation is often vaseline yarn strips etc [21]. Zheng GH [22]
treated 18 cases of abscess of iliac fossa through drainage with the use of MEBO oil yarn
strips, and all the patients were healed in 7-10 days. The author came to a conclusion:
drainage therapy with MEBO yarn strips was safe with few pains, short treatment course,
low expense and high cure rate. Zhao BS etc. [23] treated 78 cases of perianal abscess
with MEBO yarn strip drainage, and more than 90% of the patients were healed after 2-5
times of dressing change and drainage.
He thought this method had following
advantages: 1) Analgesia; 2) Anti-infection; 3) Accelerating wound healing; 4) Shortening
the course of disease, and reducing workload. Ge XF etc. [24] treated 28 cases of
perianal abscess with MEBO yarn strip drainage, 78% of the patients were healed after
3-4 times of dressing change and drainage. Kong QC etc. [25] treated 31 patients after
hemorrhoids exsection with MEBO yarn strip pressing wound, and all the patients were
healed. Compared with Yuhong ointment, a Chinese traditional medicine, the average
healing time was reduced by 7 days. Zhang CY etc. [26] treated 56 cases of Bartholin's
abscess with MEBO yarn strip tamping and drainage, the dressing was changed every
other day and more than 90% of the patients were healed after 2-3 times of dressing.
F. Infection of Incisional Wound after Operation
Infection of incisional wound after operation refers to the infection of clean wounds or
wounds likely to be contaminated. Generally, the treatment methods of it include local
physical therapy, taking out stitches and drainage, and systemic antibiotics. Deng FP etc.
[27]
provided 26 patients with incisional wound infection after operation with MEBO external
application, twice a day. Continual B-ultrasound was used monitor the changes in
infected wound. All the cases were healed without inflammation diffusion. Our

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experience is as follows: if the incision wound turns red or the patients feel pain, MEBO
should be used as early as possible, even if the patients is without fever and incision
wound is without purulence or fluctuation. The major advantages of MEBO is as follows:
1) Alleviate the inflammation; 2) Control the diffusion of infection; 3) Reduce scar formation;
4) Accelerate incision healing; 5) Relieve pains.
MEBO is the core of MEBT, the functions of which in treating different kinds of burns have
been well-known [1]. MEBO can improve the microcirculation of burn wound, and prevent
the tissues in burn wound from progressive sloughing [28]. It can lead to morphological
change of E.coli, proteus, Staphylococcus aureus and Pseudomonas aeruginosa,
disappearance of Pseudomonas aeruginosa pigment, reduction of plasma-coagulase
produced by Staphylococcus aureus, slowing-down of bacterial metabolism, anabolism,
growth and reproduction, and the decrease of their toxic actions [29]. It also has strong
broad-spectrum antibacterial actions on Clostridium tetani, Bacillus fragilis, acne
Propionibacterium and fungi [30]. Therefore, not only the effects of MEBO on wounds and
ulcers have been confirmed in clinical practice, but also it can be proved by the
pathological changes and the changes of microbiological characteristic after the wounds
and ulcers are healed. However, further studies should be conducted on the clinical
problems, such as case selection, indications, contraindications, standardization of usage,
drug interaction etc. and the pathophysiological changes of wounds after the wounds and
ulcers are treated with MEBO, so as to improve the use of this therapy and apply it in
wider clinical practice.
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About the authors
Liu Y. (1953 -), male (Han nationality), born in Zhongshan, Guangdong province,
graduated from Zhongshan Medical University in 1977, engaged in hospital management
and surgery clinical and research work. President of hospital, attending doctor.
He RL (1968- ), male (Han nationality), born in Anren, Hunan province, graduated from
Chenzhou Medical College, Hunan, graduate student on the job, attending doctor.
(Received: 2003-05-28; Revised: 2003-08-28)

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