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Application of MEBO after Operation

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					                        Application of MEBO after Operation
                             on Nasal Cavity (168 cases)

                                        Huang Qingshan, Ye Xiaoming



[Abstract] Rhinopolypus extirpation and nasal concha expiration are ordinary nasal operations.
Traditional hemostasia is using vaseline gauze strips to fill nasal cavity which can not relieve pain and
improve wounds healing and discharge. Till now there are no good methods to prevent and cure
complications after operation. Based on the characteristics of MEBO, we made MEBO gauze strip to fill
nasal cavity as the treatment after operation. According to the comparison between the 108 patients treated
with MEBO and 60 patients treated with Vaseline (control) after nasal cavity operation, MEBO gauze strip
has hemostasis, acesodyne, anti-infection effects and can improve wound healing, abbreviate period of
treatment, alleviate local edema and conglutination after operation, and reduce scars obviously. MEBO
gauze strip was applied to tamp nasal cavity in treating. It is a new specific medicinal gauze strip to
prevent and cure complications after operation. It can increase operation effects through its study and
application.

[Key Words]     MEBO gauze strip,     after nasal cavity operation, tamping

From 02/1991 to 08/1992, we made MEBO gauze strip and widely used it after nasal operation. By
compareing 108 patients treated with MEBO with 60 patients treated with Vaseline and performing
statistical analysis on the data acquired in clinical observation, we concluded MEBO had unique effects of
acesodyne, alleviating local edema, anti-infection and improving wound healing, better than those of
Vaseline. Cured scars and complications were decreased so as to improve operation effects. 168 cases are
shown as follows:

Clinical data
There were 168 patients after operation in hospital, including 90 males 90 and 78 females, aged 17-68
years, and the course of disease was 1-8 years. They were divided randomly into two groups. 108 patients
in treatment group, among which there were 50 rhinopolypus extirpation, 58 nasal concha expiration
(including mid nasal concha expiration, inferior nasal concha, antrum curettage) patients; 60 patients in
control group (including 30 rhinopolypus extirpation, 30 nosepiece expiration patients).

Treatment methods
Making methods of MEBO gauze strip: gauze strips were disinfected under high pressure and MEBO
was forged to make gauze strips for use with asceptic techniques (A great amount of MEBO was used, and
the gauze strips made need no sterilization). In the treatment group after general rhinopolypus or nasal
concha expiration, we applied MEBO gauze strip to tamp nasal cavity with the same means and tightness
as in the traditional vaseline gauze strip tamping method. Take out MEBO gauze strips from nasal cavity
every 24 hours, observe two times, apply MEBO upon wounds and keep for 3 days. In the control group,
Vaseline gauze strips were adopted for tampoing, and they were taken out and observed every 36 hours[2].
Colloidal secretion should be cleared at any time, pennyroyal compounds was applied twice a day for 3
days. In order to observe the effects conveniently, the two groups of patients did not use antibiotics and
hemostat. The patients with infection, fever, hemorrhage and unbearable pains should be treated with
expectant medication.

Clinical observation
After applying MEBO gauze strip after nasal cavity operation, edema of outer nose and nasal cavity
mucous membrane was lighter than that in the control group. After gauze strips were thaken out, the nasal
cavity was ventilated and the smell sense recovered soon. Anodyne was used 1 time in the treatment
group and 8 times in the control group because of pains (nasal pains and headache) . Anodyne using rate of
the two groups had significant difference (χ2=9.39,P<0.01) which indicated MEBO had significant
analgesic effects. In MEBO group, during tamping period and after taking out gauze strips, there was
less wounds exudation, bleeding and adhesion taking out gauze strip was easy so as to reduce pains and
avoided syncope. (Patients often swoon because of pains while taking out Vaseline gauze trip.)
Furthermore, there was no obvious jelly so as to avoid adhesion. (Generally, white downy jelly appeared
which was the sign of adhesion 2-3 days after the gauze strips were taken out .) Applying MEBO gauze
strips did not influence wounds and paranasal sinus discharge so as to prevent lachrymation, nasosinuitis,
auditory tube dysfunction Headache and fever (body temperature >38℃)         after operation were alleviated
obviously. Incidence of complications was 1.19% and 13.57% in the control group indicating it has the
functions of preventing and treating complications. (See the table) The full forming time of fibrin
membrane of wounds in MEBO group 12 hours shorter than that of Vaseline group. So we can take out
tamping in nasal cavity earlier and relieve patients’ pains. Wounds healing time was 6-26 days (average
13.5±0.36 days). In the control group, the healing time was 7-28 days (average 16±0.58 days). Wounds
healing time of two groups had significant difference (t168=3.85,P<0.01) indicating that it could
accelerate healing. In MEBO group, the mucous membrane of the wounds          recovered with elasticity, the
surface was smooth without obvious scars, contracture and hyperplasia.

                Table       Contrast of complications of the two groups after operation

Complications           Treatment group               Control group                    χ2      P
                        cases    normal               cases     normal                test
                        diseases                      diseases
                            (n)        (n)                (n)        (n)
                        (n)                           (n)
Exudation and           108           106               60           50             10.62    <0.01
bleeding                2                             10
Adhesion                108           107               60           53              7.59    <0.01
                        1                             7
Edema of mucous         108           106               60           45             20.25    <0.01
membrane                2                             15
Pains and syncope       108            107              60           55              4.18    <0.05
                        1                             5
Fever                  108             107               60           54             5.84    <0.05
                       1                             6
Wound infection        108             107               60           55             4.18    <0.05
                       1                             5
Scar formation         108             107               60           51            11.25    <0.01
                       1                             9
Total                  756             747            420            363            9.90*    <0.01
                       9                             57
* u test



Discussion
MEBO, also called Moist Exposed Burn Ointment, is widely used in clinical practice. We made MEBO
gauze strip, applied it in tamping treatment after nasal cavity operation and achieved better effects than
Vaseline gauze strip. The main effects of it are:

1. MEBO can improve wound healing after nasal cavity operation. Wounds healing time in the MEBO
group is 2-3 days shorter that in the Vaseline group. The reasons of improving healing are: First, nasal
cavity is the room for bacteria growth so wounds are prone to be infected. After applying MEBO on
wounds, it can be liquefied to form a protective drug membrane to isolate the wounds from bacteria
encroach and restrain bacteria growth thereby it has quite strong anti-infection effects and can provide
advantageous environment for mucous membrane growth and recovery and wound healing, while Vaseline
is bad for wound healing.[3] Second, MEBO contains lots of nutrients, such as saccharide, protein and
organic acid, etc., which can supply nutrition to the local areas directly and provide necessaries for the
growth and healing of wounds to mucous membrane so as to improve wounds recovery. Third, MEBO can
improve local micro-circulation and strengthen local ability of blood transportation so as to promote local
nutrient supply and then offer guarantee to mucous membrane growth and metabolism and avoid wound
healing delay caused by local nutrition absence. Fourth, MEBO can discharge automatically and keep the
wounds moist. Gauze strip made with MEBO is floppy, not stimulative, liquefied soon after filled in nasal
cavity, and can eliminate metabolites and desquamative wounds tissues in time, remove micro-circulation
obstacle, promote the growth of new tissues and retrieve vitality with slough tissues discharged without
affecting paranasal sinus excretion and auditory tube function. Moist environment provides a good
condition for cell growth in favor of wound healing.

2. MEBO has obvious analgesic effect. In nasal operation, narcosis tissues of exterior mucous
membrane make patients feel pains during operation and the pains are worse after operation. Applying
MEBO gauze strip tamping can relieve pains after operation and improve diet and sleep, strengthen
immunity, remove the worries about the pains during taking out gauze trip. The mechanism of acesodyne
is: First, the protective membrane on the wounds replaces fibrin membrane (The protective membrane of
MEBO is actually a mixed membrane of fibrin in secretion and MEBO altogether), and can avoid pains
caused by bacteria and toxin. Second, drugs in MEBO have quite effective anti-inflammation and
anti-infection functions and can alleviate edema oppressive pains caused by local wounds. Third, MEBO
can excrete exudation and metabolites via automatic circulation drainage so as to avoid them kept on the
wounds which results in pains. Fourth, MEBO gauze strip is floppy and has some cushion after filled in
nasal cavity so as to avoid reflected headache caused by tamping. Based on analgesic mechanism, applying
MEBO has perfect effects.

3. MEBO can alleviate scar formation. By improving local blood circulation, MEBO accelerates
metabolism and prevents the deformation of mucous membrane epithelia in moist environment caused by
growth setting change, relieves fibrin cell hyperplsia and alleviates scar formation. After the wounds heal,
mucous membrane has good elasticity, slippery exterior, there is no apparent atrophy and hyperplasia, this
is very important for the recovery of ventilation and smell sense [4] , and can reduce recurrence of disease.
The effects of MEBO in keeping nasal cavity moist, avoids membrane desiccation and bleeding caused by
respiration airflow and reduces conglutination rate of wounds and the surrounding tissues.

4. MEBO can prevent tissue edema around the wounds. In nasal operation, there is great stimulation to
mucous membrane because of repeatedly putting appliances in and out which results in edema after
operation. MEBO gauze strip is good for alleviating mucous membrane edema with the following reasons:
First, MEBO has effects of automatic circulation drainage to eliminate metabolites of tissues to avoid
tissue edema. Second, MEBO has anti-infection function and can alleviate local inflamed edema. Third,
MEBO has protecting effect so as to avoid edema caused by bacteria toxin.

5. MEBO gauze strip has tamping hemostasis effects [5]. The protective membrane caused by MEBO
gauze strip filled in nasal cavity and the pressure can stanch effectively. After taking out gauze strip the
stimulation of respiration airflow will cause fibrin membrane desiccation and bleeding. Applying MEBO
upon wounds and surrounding mucous membrane can keep moist os as to protect them and avoid bleeding
after operation. Till now no hemostatic tamping matters have effects of analgesic, improving wounds
healing and preventing complications after operation. We apply MEBO gauze tamping for multi-prupose.
It has been proved by clinical observation that MEBO gauze strip is a new-generation tamping and ought
to be popularized.

[Reference]
[1]   Xu RX, Summary of burns, wounds and ulcers (I), The Chinese J. of Burns Wounds & Surface
    Ulcers, 1989,(1): 11.
[2]   Wang SX (chief editor), Surgery of ears, nose and throat. Tianjin Renmin Publishing House, 1976,1,
    front page, 282-326.
[3]   Yang SB et al. Application of MEBO after excision and drainage of abscess. The Chinese J. of
    Burns Wounds & Surface Ulcers, 1992,(2): 40.
[4]   Huang QS et al. Report of MEBO in treating 34 cases of atrophic rhinitis. 2nd West-East national
    seminar of ears, nose and throat, Materials of communication, 1992,6.
[5]   Huang QS et al. Discussion on the application of MEBO in treating 63 cases after tonsillotomy. The
    Chinese J. of Burns Wounds & Surface Ulcers, 1991,(4): 55.

				
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