Treatment of Burns, as Well as Blast Injuries, in Their ‘Own Liquid Medium’—33 Years of Experience of Surgeon V.A. Menzul: Proposed Mechanisms and Current Data

The treatment of burns and war injuries remains a pressing issue. Since 1993, surgeon V.A. Menzul has been using a special polyethylene film to cover wounds. This film interacts only minimally with the wound surface, so it does not interfere with regenerative processes and makes dressing changes painless. Exudate flows from the wound and is absorbed by the layers of dressing situated above the film. Over time, a membrane forms beneath the film, consisting mainly of fibrin and a large number of white blood cells (the fibrin–leukocyte membrane, FLM). The FLM and the exuding fluid perform several functions: they create a moist environment and mechanical protection; they deliver materials and immune cells to the wound site; they remove toxic breakdown products; and they exert an antimicrobial effect. The latter consists of a direct barrier effect and the recruitment of immune cells. Such an “own liquid medium” (OLM) technique with a transparent film allows the process to be observed. The results of this treatment, in comparison with the traditional dry treatment method, shorten the length of hospital stay, reduce patients’ discomfort and lead to improved cosmetic outcomes. This narrative review discusses various aspects of the OLM treatment technique. We believe that Dr Menzul’s experience should be made known to a wide range of healthcare professionals.