After removal of liquefied necrotic tissues, a fibrous isolation membrane is formed on the wounds surface like a layer of transparent cornea. 

It is very important to protect this membrane (to be explained later).

In clinical practices, wound necrotic tissue liquefaction should be distinguished from wound infection. 

Infection is a process that inflammation reaction is taking place in viable tissues affected by pathogenic bacteria. 

Infection always brings on the purulence and necrosis of living tissues.

Infection is always characterized by local redness, swelling, fever, pain and dysfunction. 

While, liquefaction is a process that necrotic tissue under the action of MEBO is turned automatically from solid state to liquid state and be removed without causing any further damage. There is no living tissue involved in this process. 

Figure: On day4, the wounds began to liquefy under the action of MEBO, and wound skin began to regenerate

A layer of milky white or milky yellow, homogeneous, fine and smooth semi-fluid substance is formed on the wounds and is removed through changing of the dressings without causing any damage. 

The following principles should be followed:

A.Early application of the drug: 

It is recommended to apply the drug within 4 hrs post injury. 

The purpose is to save the tissues in the stasis zone of the wounds and prevent progressive necrosis to ensure the efficacy of thie treatment.

B. The drug should be applied in the whole course of the treatment without interruption: 

No other drug or treatment should be used to replace it in the whole course of treatment. 

Dry therapy and astringent drugs are forbidden. 

Antiseptic agent is not allowed to apply directly on the wounds. 

Don't use water to wash the wounds.

C.Wound dressing change should be carried out in a standardized procedure: 

Liquefied products should be removed every 4 hrs. 

Handle carefully, follow the "Three DON't Principle" 

• don't cause pain, 
• don't cause bleeding 
• and don't cause any further damage in the normal skin tissue. 

It is veiy important to protect the fibrous isolation membrane to cover the wound. 

Adhere to the "Three DON'T principle" so that physiological regenerative repair of the wound can be achieved.

D.  Wound treatment: 

"Three timely principles" is one important principle in the management of wounds, i.e.

• timely removal of liquefied products,
• timely removal of necrotic tissue 
• and timely application of the drug. 

Another key principle is "Three no accumulation", i.e.

• no accumulation of necrotic tissue, 
• no accumulation of liquefied products 
• and no accumulation of excessive drug (MEBO).
  

In the treatment of large area burn wounds, it is veiy important to strictly follow the above principles not only to ensure quick healing of the wounds, but also directly related to the systemic condition and recovery of the patients.