( Moist Exposed Burn Ointment )

RSUD 45
Kuningan
19 Januari 2012

Permasalahan Pada Luka

1. Gangguan Bakar
jalan nafas dan pernafasan (A-B)
2. Gangguan sirkulasi (C)
3. Gangguan Gastrointestinal
4. Gangguan sel otak
5. Gangguan ginjal
6. Gangguan sel sel otot
7. Gangguan jantung dan hematologi
8. Gangguan elektrolit

9. Kontraktur dan parut hipertrofik

(wound management)

Note :
A : Airway
B : Breath
C : Circulation

Conventional Therapy (skin graft)

Pria, 31 thn. TBSA=96%

III65% deep II 31%

Kondisi setelah sembuh,

hipertropi, scar dan disability

Disability rate of big area Surface burn

100%

13%

Process of Regeneration and

Replication by PRCs

Process of In-situ
Regeneration

Liquefaction Action
(Autolitic Debridement)

Physiological Moist
Enviroment
Normal Skin

Burn Wound

Treatment

--

MEBO

Vaseline

Dry
Exposed

Evaporative Rate
(g/sq.m. . h)

4.5~5.0

5.0~6.0

1.5~2.0

60~80

Pathological
Necrosis Residual
Changes

Normal

Residual tissues
repaired

Wet necrosis of
residual tissue

Dry of
tissue

Comparison rate of moisture evaporation at the wounds treated with

MEBO, Vaseline and Dry-exposed, and with just normal skin

Illustration of Physiologically Moist

Environment on Burn Residual Tissue
Created by MEBT/MEBO for Treatment
MEBO
ointment
layer
Transparent
Membrane

Residual
Skin
tissue

Respiratory function: excess exudation is discharged;

nutrients and effective drug elements are absorbed.
Exudation

The amount of discharged water

Prinsip Penanganan Luka

(BRT-MEBO Standard
Application)

No
No
No
No

pains
bleeding
dryness
scar

Metode Terapi MEBO

(Burn Regenerative
Therapy)
Exposed Therapy (terbuka)
Semi-exposed Therapy
(semi terbuka)
Bandaging Therapy
(tertutup)
Kombinasi terapi dengan
bandaging dan exposure.

<> Exposed Therapy

(Terbuka)

Oleskan salep MEBO dengan

Ganti dressing MEBO setiap 4-6
ketebalan 1 mm, keluarkan cairan jam dan bersihkan produk liquefy
dari dinding Blister (aspirasi)
serta sel nekrosis

<> Exposed Therapy

(Terbuka)

Produk liquefy

Penggantian dressing dengan

meletakkan kasa steril kering

Kemudian, angkat kasa

perlahan-lahan

<> Exposed Therapy

(Terbuka)

Right

Wrong

Kassa
Luka
Perhatian : Tidak boleh mengusap luka dengan kassa

<> Exposed Therapy

(Terbuka)
Luka terlihat bersih

Hari ke 21, kulit telah sembuh tanpa

terbentuk jaringan parut

Kembali oleskan salep MEBO

dengan ketebalan 1 mm

<> Semi-exposed Therapy

1

1.

Pembuatan MEBO gauze

(steril): Kassa steril kering
dibalurkan salep MEBO secara
merata

2.

Letakkan MEBO gauze steril ke

bagian luka

3.

Produk liquefy yang terbentuk

maupun sel nekrosis harus
dibersihkan

<> Semi-exposed Therapy

2

1.

Bersihkan produk liquefy

dengan cara diperban (angkat
setelah 10-30 detik) atau dengan
lekatkan kassa steril untuk
absorbsi

2.

Persiapkan MEBO gauze steril

baru dan letakkan pada luka
yang sudah bersih

3.

Ganti dressing setiap 2-3x

sehari

<> Bandaging Therapy

(Tertutup)
Cotton dressings and Perban
(2-3cm)
1-2 lapis MEBO gauze steril
Oleskan salep MEBO 2-3 mm
Kulit luka

Perhatian: Perban dengan tekanan rendah

<> Bandaging Therapy

(Tertutup)

1. Bersihkan luka dengan

kassa, oleskan salep MEBO
2-3 mm
2. Letakkan 1-2 lapis MEBO
gauze steril pada luka
3. Tutup dengan cotton
dressing
4. Ganti dressing setiap 1-2x
sehari

>> Perhatian :
Bila kondisi luka kotor berwarna
hitam, atau terkena zat kimia bisa
dibersihkan 1 s/d 2 kali dengan
normal saline. Jangan
membersihkan luka dengan
desinfektan/larutan antibiotik
Pembersihan selanjutnya dengan
cara kering yaitu absorbsi dengan
kassa kering steril
Bila ditemukan adanya infeksi
(sesuai kultur), berikan antibiotik
oral/injeksi (mis: Ceftriaxone
(Tyason), dll) selama 3-5 hari. Bila
suhu tubuh pasien normal, hentikan
pemakaian antibiotik
Luka dijaga tetap moist, bila MEBO

Multicenter Study
Komparasi MEBO vs SSD
508 kasus luka bakar di 5
pusat luka bakar (Burn
Center)
Conclusion :
Kesembuhan lebih cepat
Minimal Scar dan Disability

Result <<
Clinical Trial MEBO vs Silver Sulfadiazin (SSD)
on burn second-third degree

Graphic 1. Burn superficial second degree

Result <<

Graphic 2. Burn depth second degree

Conclusions :
1. Faster of healing time
2. Minimal scar formation
3. Minimal skin grafting

Graphic 3. Burn third degree

Kelebihan MEBO
dibandingkan
SSD
MEBO memiliki kemampuan
me-liquefy sel

nekrosis sedangkan SSD tidak mampu menembus

lapisan nekrosis (hanya di permukaan saja)
sehingga obat tidak bekerja maksimal
MEBO membantu proses regenerasi sel dengan
memberi nutrisi dan oksigen
MEBO nyaman diberikan pada daerah luka (tidak
perih atau panas)
MEBO menjaga luka tetap moist dan menghindari
kehilangan cairan lebih banyak
MEBO aman diberikan jangka panjang karena
tidak mengandung bahan berbahaya, sedangkan
SSD mengandung perak (silver) yang bila
diberikan pada luka terbuka bisa terabsorbsi
secara sistemik dan berbahaya menyebabkan
nefrotoksik

Case in Immanuel
Hospital, Bandung
Man, Electrical Burn
30.000 volt
TBSA 45%
Head & Foot (deep third
degree 6%)
Chest & Abdomen
(superficial third degree 6%)
Torax & Neck (deep second
degree 33%)

Wound Management
Debridement
Drilling Technique
Micro Skin Planting
Technique
Skin Flap

Result <<

anulation on Drilling Area

rilling Technique) Combine
with Skin Flap
Skin closed after 41 days

xth Month after follow up

No Scar or Hypertonic

6 months

Result <<

cro Skin Planting Technique

on granulation site
New skin grew up and
82 days closed the wound

Hari ke
82

6 bulan

Clinical Experience with MEBO

Case :
Boy 3 years, TBSA=90% (40% deep II
degree burn)
Recovery at 34 days, without scar

Clinical Experience with MEBO

4th day post injury

Case :
Boy 2 years 6 months, TBSA=85% (III
degree 35%, deeply II degree 30%)
56th day post injury

Clinical Experience with MEBO

On 13th days
after treatment

Post Injury

On 46 days
after treatment
th

Good Elasticity

Case :
TBSA=92%. (deep III degree, 6%,
superficial III degree, 20 ,deep II

After treatment with MEBO

Before treatment

Case : male, 1st and 2nd Degree Burn Wound

7 days

15 days
Photo by : dr Hardisiswo S, SpBP (RSHS-BDG)

Photo by : dr Richard Z, SpB (RSY-JKT)

After treatment with MEBO for 21 days

Before Treatment

Male : 2nd and 3rd degree burn

wound 54% TBSA

MultiCeter Study SSTDS

Komparasi MEBO vs
Vaseline

- Analgesia Effect
- Shorten healing time

Result <<

lusions of MEBO :
ster of healing time
tter scar quality
nimal pain respond
hile dressing changing

Vaseline

Skin Donor Site after harvesting

Four days post operation

MEBO

Treatment with MEBO and Vaseline gauze

Nine days post operation, MEBO already heal

But on Vaseline gauze still stick on the site

Study 1. Comparing MEBO vs Sofra-Tulle

MEBO

Sofra-Tulle

nclusions of MEBO:
Faster of healing time
Less hyperemic &
ess pigmented

Secondary healing of STSG donor site

with MEBO, Sofra-Tulle and Tegaderm

Better quality scar is observed with MEBO

MEBO on Chronic Wound

Tendon exposed

Female, 58 years. History of diabetes 5 years. Have infection after trauma

Treated after 18 days

Treated after 38 days

MEBO on Chronic Wound

15 cases of foot diabetic ulcer
Systemic treatment : anti-hyperglycemia treatment
anti-infection treatment : first line : 3 rd Cephalosporin or Metronidazole
systemic nutrition : albumin
Local treatment : debridement and drainage, MEBO dressing
Typical case : Female, 42 years old, refuse to amputation from another hospital

Before treatment with MEBT/MEBO

75 days after MEBO treatment

90 days totally heal, without

Amputation and physical disability

Female, 56 years, with Chronic Gangrene

Female, 56 years old, with

years of diabete history.

The chronic ulcer at the

left leg healed in 60 days.

During treatment with MEBO

Before treatment with MEBO

Male 61 years old with deep ulcer

cause bed sore with infection

After treatment
with MEBO for
110 days

MEBO on Chronic Wound

Before Treatment

On 120 days after treatment

Ref : Rongxiang Xu, Clinical Handbook for Burn

Regenerative Medicine and Therapy

Product Profile
Ingredient
: Radix Scutellariae, Phellodendri Cortex,
Rhizoma Coptidis,
Oleum Sesame, Cera Flava
(components : 18 amino acids, 4 fatty
acids, 7
polysaccharides, vitamins, -sitosterol)
Mode of Action : Supply of oxygen and nutrition,
Physiologically
moist environment, Exogenous tissue culture
medium, Initiation& Activation of stem cell,
Discharge necrotic tissue by liquefaction, Control
bacterial infection and toxin.
Indication
: Promote wound healing and tissue
regeneration
Preparations : Ointment,Tube 20 gr & 40 gr
www.MEBO.com
www.CHINABURN.org

CETERON

Injeksi 4mg dan

8mg dan Tablet
4 mg

Pilihan Terpercaya Mengatasi Mual dan Muntah

Tyason
Ceftriaxone inj 1 gr/vial

Cepat

&

Kuat

Cepat mengatasi infeksi serius dengan spektrum luas

Tahan terhadap enzim -laktamase
Penetrasi tinggi & bersifat bakterisidal

COMBICEF
(Cefotaxim)
Kandungan : Cefotaxime 1 g
Kemasan : Box, 1 vial
HNA : Rp. 115.500,-/vial

>>> Terima
Kasih
Doni Azmar