title: Spray-on-skin cells in burns: a common practice with no agreed protocol.
abstract: OBJECTIVE
  Cultured epithelial autograft (CEA) has been used for skin coverage after burn wound excision since 1981. It is used in burn units and centres throughout the U.K.; however, there appears to be no agreed standards of practice. We aimed to investigate the experience and current practice with its usage in the management of acute burn injury.
  
  
  METHODS
  An online survey was sent to twenty-five burns consultants in the U.K., who are members of the British Burn Association.
  
  
  RESULTS
  We received 14 responses. Rarely have the responders agreed to the same practice in most of the questions. Different choices were given by responders with regards the indications for cell culture, techniques used, primary and secondary dressings used, first wound review timing, and measures used to evaluate outcomes.
  
  
  CONCLUSIONS
  In the current economic environment, the NHS needs to rationalize services on the basis of cost effectiveness. CEA is an expensive procedure that requires an adequately sterile laboratory, special equipments and highly experienced dedicated staff. When dealing with expensive management options, it is important to have an agreed protocol that can form the standard that can be referred to when auditing practices and results to improve burn management and patients' care.
authors.affiliation: Burns and Plastic Department, Queen Elizabeth Hospital Birmingham, Birmingham, West Midlands B15 2TH, UK. Electronic address: allouni@hotmail.com.
authors.forename: Ammar
authors.initials: A
authors.lastname: Allouni
authors.forename: Remo
authors.initials: R
authors.lastname: Papini
authors.forename: Darren
authors.initials: D
authors.lastname: Lewis
mesh_terms: D000208:Acute Disease; D002056:Burns / Q000628:therapy*; D018929:Cell Culture Techniques / Q000379:methods; D002478:Cells, Cultured; D002985:Clinical Protocols / Q000592:standards*; D004847:Epithelial Cells / Q000637:transplantation*; D006302:Health Services Research; D006801:Humans; D010818:Practice Patterns, Physicians'; D016038:Skin Transplantation / Q000379:methods*; D011795:Surveys and Questionnaires; D006113:United Kingdom
keywords: Burn; CEA; Cells; Cultured epithelial autograft; ITU; Spray; TBSA; cultured epithelial autograft; intensive treatment unit; total burn surface area