Burns Clinical Trial
Official title:
Randomized Single-center, Single-blind, Two-arm Parallel Group Trial of Using MEBO™ Dressing Versus Standard Care at Zagazig University Hospital in the Management of Donor and Recipient Sites of Split-thickness Skin Graft
40 Egyptian Cases with split-thickness skin graft receiving treatment at Zagazig University
Hospitals. Study Duration:6 Months .Description of Agent or Moist Exposed Burn Ointment
(MEBO).
Intervention:
Objectives: Primary: to determine the efficacy of MEBO versus standard care in improving the
healing speed and re-epithelization process of skin graft donor and recipient sites.
Secondary to determine the efficacy of MEBO in decreasing recovery time, rate of infections,
rate of complications, total treatment costs and its effect on improving pain alleviation.
Description of Study Design: Arm 1 20 MEBO at sites of donor graft and recipient at time of
operation and in dressing Arm 2 20 Standard cream Zagazig University Hospital (Antibiotics &
analgesics) Estimated Time to Complete 5 months
Background Information.
Skin grafting is a frequently used technique for covering skin defects in cases of row area.
The technique evolved from use in the back alleys of India in pre-Christian times to become
one of the most valuable clinical tools in modern surgery. There are several techniques for
caring for the skin graft site to assure an adequate graft and prompt as well as wound
healing.
The use of the split-thickness skin graft (STSG) as reconstructive technique is very common
nowadays but this technique is usually a source of pain and discomfort for the patients and
may cause significant morbidity and result in hypertrophic or even keloid scarring. The wound
heals by a process of re-epithelialization which results in an epithelial cover usually
within 7-14 days. The aim of graft management is to maintain an environment that promotes
optimal healing and prevents morbidity, which can include pain and infection and ultimately
delayed healing.
The dressing of donor and recipient sites which provides a protective barrier should be easy
to apply, promote rapid re-epithelialization, and be pain free, infection free, and
relatively inexpensive.
MEBO have been proved to have anti-inflammatory and anti-microbial effect due to the presence
of - β sitosterol and berberine respectively. Many studies have reported that MEBO provides
suitable moist environment needed for burn wounds for optimal healing and
re-epithelialization without the need for wound closure by dressing. Also some studies have
proved the efficacy of MEBO in secondary healing of partial thickness wounds, such as split
thickness skin graft sites, with improved cosmetic results and better scar quality.
In cases of raw area, donor and recipient sites have been traditionally dressed with
low-adherent wound contact paraffin gauze or antibiotic-impregnated tulle gras and covered by
a secondary dressing made of gauze and absorbent padding.
These dressings are relatively inexpensive. However, during the peri-operative period,
patients complain more often of discomfort or pain at the donor area than at the graft site
itself besides, the poor cosmetic appearance of donor sites after healing is not readily
accepted.
Because the basic pathology of burns closely mimics many aspects of skin graft donor sites,
researchers are investigating using MEBO at donor and recipient sites.
Potential Risks
Due its pure and natural origin, MEBO have been reported to have no side effect or potential
risks except rare cases of allergy and hypersensitivity.
Known Potential Benefits
MEBO has been proved to have a positive effect on improving healing process with rapid
re-epithelialization. According to a recent study, the burn areas and graft sites were
markedly less hyperemic and less pigmented and the final cosmetic appearance and patient
satisfaction were also higher by using MEBO. The cases who used MEBO had better scar
assessment and lower pain scale.
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