Is Mebo (moist exposed burn ointment) suitable for facial use?

MEBO Ointment for Facial Burns

MEBO (Moist Exposed Burn Ointment) is a suitable and effective alternative for treating partial-thickness facial burns, offering easier wound assessment, convenient dressing changes, and comparable healing outcomes to conventional treatments.

Evidence Supporting Facial Use

Comparative Effectiveness

• MEBO demonstrates similar healing rates to silver sulphadiazine for partial-thickness facial burns, with the key advantage of minimal slough formation allowing clearer assessment of healing progression 1
• In a comparative study of 60 facial burn patients, MEBO provided excellent pain relief, easier patient movement, and good healing properties, making it an excellent choice for facial burn management 2
• MEBO-treated facial burns showed mean re-epithelialization time of 12.4 days compared to 10.5 days with Aquacel Ag, though this difference was modest 3

Specific Advantages for Facial Application

• Ease of assessment: Unlike silver sulphadiazine which forms an overlying slough, MEBO allows continuous visual monitoring of wound healing without obscuring the burn surface 1
• Patient comfort: MEBO causes significantly less pain and itching compared to saline-soaked dressings, and allows easier facial movement than occlusive dressings 2
• Convenient application: The open dressing technique with MEBO is easier to apply and change on facial contours compared to adherent dressings 1, 2

Mechanism of Action

• MEBO promotes activation and proliferation of epidermal stem cells (demonstrated by enhanced cytokeratin 19 expression), facilitating wound regeneration in partial-thickness burns 4
• The moist environment provided by MEBO supports physiological wound healing while maintaining wound exposure for assessment 5

Application Protocol for Facial Burns

Initial Management

• Cool the burn with clean running water for 5-20 minutes immediately after injury 6, 7
• Clean the wound with tap water, isotonic saline, or antiseptic solution 6, 7
• Decompress blisters by piercing and aspiration while preserving the blister roof as a biological dressing 7

MEBO Application Technique

• Apply MEBO ointment directly to the facial burn surface in a thin layer 1, 2
• Use the open dressing technique (moist exposed method) - no occlusive covering required 2
• Change dressings as needed based on wound assessment, typically daily 6, 7
• Continue application until 75% reduction in burn surface area is achieved 1

Important Caveats

When MEBO May Not Be First Choice

• If frequent dressing changes are difficult for the patient or family to manage, occlusive dressings like Aquacel Ag may be preferable as they require less frequent changes 2, 3
• Some patients may find the odor of MEBO unacceptable, in which case alternative dressings should be considered 2
• Occlusive dressings (Aquacel Ag) showed slightly faster healing (10.5 vs 12.4 days) and potentially better long-term scar outcomes in one study 3

Critical Safety Considerations

• Avoid ice application: Never apply ice directly to facial burns as this causes additional tissue damage 7, 8
• Monitor for infection: Apply topical antimicrobials only to sloughy areas, not prophylactically to the entire burn surface 7
• Avoid prolonged silver sulfadiazine: Do not use silver sulfadiazine for extended periods on superficial facial burns as it may delay healing 7, 8

When to Seek Specialized Care

• All facial burns warrant medical evaluation regardless of size due to cosmetic and functional importance 6, 7
• Burns involving eyes, nose, mouth, or ears require immediate specialist assessment 6
• Signs of infection (increased pain, redness, purulent discharge) necessitate urgent re-evaluation 7
• Deep partial-thickness or full-thickness facial burns require burn center management 6, 7

Practical Advantages Over Alternatives

• Versus silver sulphadiazine: MEBO provides clearer wound visualization and easier dressing changes without the obscuring slough formation 1
• Versus saline dressings: MEBO causes significantly less pain, less itching, faster healing, and better patient satisfaction 2
• Versus occlusive dressings: MEBO allows continuous wound assessment and easier application to facial contours, though occlusive dressings may heal slightly faster 2, 3