Title:

Integrating MEBO in the best western management of “Hard-to-Heal” wounds:

A 20 years Lebanese experience.

Author:

Jamil Halabi, MD

General Surgeon and Chronic Wounds Expert,

Faculty of Medicine, University Of Balamand,

LEBANON

Keywords: hard-to-heal wounds, moist, limb salvage, MEBO, TIME criteria, best western practice, diabetic foot, pressure ulcers.

Abstract:

Purpose:

To prove the advantages and added value of integrating Mebo in the traditional western management of Hard-to heal wounds in diabetic foot ulcers and pressure injury patients previously called pressure ulcers.

Methods:

Patients with stagnating wounds, treated by colleagues who follow western medicine wound management techniques, were enrolled in a Mebo-based wound management approach, while respecting all western medicine principles of wound management, in my clinic, over a 20 years period (1997-2017).

All stagnating chronic wounds were surgically debrided and transformed into acute wounds.

A daily wound care session strictly following the “TIME” criteria of wound managent was started in all patients.(t=tissues in the woundbed, i=infection/inflammation, m=moist environment, e=edges of wound).

I integrated MEBO in all patients, to ensure the Moist of this TIME criteria.

Results:

Integrating MEBO resulted in a significant improvement in all my patients.

Patients with a good blood supply achieved  rapid and nice complete healing.

Non-revascularisable patients also improved markedly after integrating Mebo.

Many non-revascularisable diabetic patients, unexpectedly, healed their feet ulcers.

Minor amputations were sometimes performed in advanced ischemia cases.

Major amputations were extremely rare.

Conclusion:

Integrating MEBO to the classic “TIME”criteria of western wound management resulted in a significantly better wound healing and a lower rate of minor amputations and a very low rate of major amputations in diabetic patients. Limb salvage rate can be significantly improved by integrating MEBO to the classic western rules of wound management.

Pressure injuries (previously called pressure ulcers) also showed a much shorter  healing time and a better healing tissue quality.