A Controlled Randomized Trial Assessing Regenerative Therapy in Healing of
Chronic Pressure Ulcers
Mahmoud F. Sakr
1*
, Hossam M. Hamed
2
, Chen Y. Chong
3
Alexandria, Egypt ; Ahmadi Hospital, Kuwait Oil Company (KOC),
Ahmadi,
Kuwait;
3
ABSTRACT
Aim: To assess the efficacy and safety of regenerative therapy as compared to wet-to-moist saline dressings in healing
of chronic pressure ulcers (CPUs).
Method: Consecutive patients (n=105) with CPUs (n=218) treated at three different hospitals were randomized to
receive Moist Exposed Burn Ointment (MEBO) dressings (Regenerative group, n=55 with 115 ulcers) or wet-to-moist
saline dressings (Control group, n=50 with 103 ulcers). Data collected prospectively included demographics, clinical,
biochemical and ulcer features. Ulcer surface area (SA) and healing index (HI) were calculated and compared at two-
week intervals for 12 weeks.
Results: Sixty-one patients (58.1%) were male and 44 (41.9%) were female. Their mean age was 69.5 years. There was
an increase in HI and reduction in SA starting at two and four weeks, respectively in the regenerative group. At 12
weeks, 61.7% (71/115) of ulcers treated with MEBO had complete healing (HI=1) versus 28.2% (29/103) of controls
(p=0.000). None of the patients receiving MEBO had a HI of<0.5 at 12 weeks as compared to 25.2% of controls
(p=0.000). Significantly (p<0.01) more grade 2-4 ulcers healed completely with MEBO by 12 weeks. No adverse effects
or allergic reactions were noted by 12 weeks.
Conclusion: In addition to its safety, MEBO significantly promotes the healing of CPUs with significant increase in
HI of any given ulcer as early as two weeks of treatment, and significant reduction of ulcer SA starting at four weeks
with complete healing of more than 60% of ulcers by 12 weeks.
Keywords: MEBO; Moist exposed burn ointment; Regenerative therapy; Pressure ulcers; Chronic wounds; Healing
index
KEY MESSAGE
Regenerative therapy using MEBO dressings three times daily
significantly promotes healing of chronic pressure ulcers
irrespective of their size, site, grade or underlying predisposing
factor, with significant increase in healing index as early as 2
weeks of initiation of therapy reflected by a significant reduction
of ulcer size.
INTRODUCTION
Pressure ulcers constitute a clinical challenge for both clinician
and patient [1-3]. The clinical evidence that a moist environment
is the single most important external factor responsible for
optimal wound healing is overwhelming [4-7]. Moist Exposed
Burn Ointment (MEBO) (ShanTou MEBO Pharmaceutical CO,
LTD, China), popularized by Xu Rong-xiang has shown evidence
over the past 30 years of promoting wound healing both in the
experimental and clinical setting, albeit without many properly
conducted randomized controlled trials (RCTs) [8-17]. This RCT
was conducted to assess the safety and efficacy of regenerative
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ISSN: 2684-1606
Journal of Surgery and Anesthesia
Research Article
*
Corresponding author: Mahmoud F. Sakr, Department of Surgery, Faculty of Medicine, Alexandria University, Alexandria, Egypt, Tel: 002 0100
7834993; E-mail: mah_sakr@yahoo.com
Received date: September 16, 2019; Accepted date: September 25, 2019; Published date: September 30, 2019
Citation: Sakr MF, Hamed MH, Chong YC (2019) A Controlled Randomized Trial Assessing Regenerative Therapy in Healing of Chronic Pressure
Ulcers. J Surg Anesth 3:1. doi: 10.35248/2684-1606.19.3.124
J Surg Anesth, Vol.3 Iss.2 No:1000124
1
1
Department of Surgery, Faculty of Medicine, Alexandria University,
2
Department of Surgery,
Department of Burns, Wounds and Ulcers of Beijing Nanyuan Hospital, Beijing, China
permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Copyright: © 2019 Sakr MF, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which