title: The use of Flammacerium in British Burns Units.
abstract: BACKGROUND
  Flammacerium (cerium nitrate-silver sulphadiazine) is marketed throughout Europe, but is only available in UK on a named patient basis. Anecdotally it is widely used in civilian burns units across the country despite the regulatory constraint, although little literature exists regarding its use in UK. We designed a postal survey to assess the use of Flammacerium countrywide and whether its 'named patient only' designation causes problems in treating burns patients.
  
  
  METHODS
  Postal questionnaires were sent to the directors of the 18 adult burns units listed by the British Burns Association, requesting information on the use of Flammacerium. The indications and limitations of its use were recorded, as were any problems obtaining supplies. Finally, burns units were asked if they would like to see Flammacerium fully licensed in this country.
  
  
  RESULTS
  Replies were received from 14 units (response rate=78%). Six units use Flammacerium frequently, six occasionally and two units never use it. It is used in those patients not undergoing early wound excision and closure because of co-morbidity, general age or frailty, paucity of donor sites or mixed depth pattern burns. It was generally used in the belief that it reduces the inflammatory response to burn injury (8/12), decreases bacterial colonization (10/12) and provides a firm eschar for easier wound management (11/12). Although 8 units had no problems with supplies of the agent, 10 respondents indicated they would like to see Flammacerium fully licensed in UK.
authors.affiliation: Specialist Registrar in General Surgery, Chesterfield Royal Hospital, Calow, Chesterfield, Derbyshire S44 5BL, UK. jeffgarner@doctors.org.uk
authors.forename: J P
authors.initials: JP
authors.lastname: Garner
authors.forename: P S J
authors.initials: PS
authors.lastname: Heppell
mesh_terms: D001291:Attitude of Health Personnel; D002053:Burn Units / Q000706:statistics & numerical data*; D002056:Burns / Q000188:drug therapy*; D002563:Cerium / Q000008:administration & dosage*; D004338:Drug Combinations; D004363:Drug Utilization; D019538:Health Care Surveys; D006801:Humans; D008004:Licensure; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012837:Silver Sulfadiazine / Q000008:administration & dosage*; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D004338:Drug Combinations; C046337:cerous nitrate, sulfadiazine silver drug combination; D002563:Cerium; D012837:Silver Sulfadiazine