FLAMMACERIUM CREAM SIZE: GENERIC NAME: CERIUM NITRATE AND SULFADIAZINE MANUFACTURER: DUPHAR B.V UNIT: ADMINISTRATION ROUTE: FDA PREGNANCY GROUP: B INDICATIONS: Burns SIDE EFFECTS: Erythema multiforme fungal proliferation in and below the eschar increased sensitivity of skin to sunlight interstitial nephritis leukopenia skin necrosis Burning feeling on treated area(s) Brownish-gray skin discoloration itching or skin rash ABSOLUTE CONTRAINDICATIONS : RELATIVE CONTRAINDICATIONS : Blood dyscrasias Glucose-6-phosphate dehydrogenase deficiency Hepatic function impairment Porphyria Renal function impairment ADULT DOSE: Burn wound infections or [Skin infections, bacterial, minor] or [Ulcer, dermal]- Topical, to the affected area(s), one or two times a day, applied in a thin layer approximately 1.5 mm thick. Note: In some other countries, silver sulfadiazine is customarily applied less frequently (e.g., three times a week), in a 3- to 5-mm layer. However, USP medical experts prefer application one or two times a day in a 1.5-mm layer. MAXIMUM ADULT DOSE: Main Ingredients: Radix Scutellariae, Cortex Phellodendri Chinensis, Rhizoma Coptidis, Beeswax, and Sesami oil PEDIATRIC DOSE: Burn wound infections or [Skin infections, bacterial, minor] or [Ulcer, 2 months of age-Use is not recommended, since sulfonamides may cause kernicterus in these neonates. Functions and Indications: Infants and children 2 months of age and over-See Usual adult and adolescent dose. Product Description: dermal]- Premature and newborn infants smell Light yellow-brown ointment with sesame oil up to • • • • • Clear away heat and toxic materials, subside swellings, relieve pains and promote granulation; analgesic, anti-inflammation, anti-infection, ulcer-management, liquefying and removing necrotic skin tissues without causing further injury, physiological regeneration and repair of skin, promoting the wound healing, mitigating injuries and lessening scar formation. MAXIMUM PEDIATRIC DOSE: ELDERLY DOSE: Applications: 1. Acute Wounds • Burn wounds including first degree, superficial second-degree, deep second-degree superficial type, deep second-degree deep type,superficial third-degree,and deep third-degree burn wounds, burn wounds on bone, electronic burns and severe chemical burns Surgical wounds including donor site wounds, cosmetic surgical wounds, ostomy wounds, wounds of circumcision, obstetrical wounds Pressure wounds Amputated limbs • • • 2. Chronic Wounds (Typical Clinical Cases Profiles) • • Diabetic ulcers Pressure ulcers (Bedsore) Soft tissue necrosis • • • • • Chemotherapeutic phlebitis Radioepidermitis Herpes zoster Newborn diaper dermatitis Common warts Mechanisms • • • • • • • Regeneration of skin organ in situ after deep burns via keratin-19 positive expressed epidermis stem cells; Analgesic effects by protecting nerve endings and relaxing arrectors pilorum; Wound protection by a unique sponge-like frame structure dosage form, which creates a physiological moist environment to keep the barrier function of burn wound in early stage; Anti-inflammatory by the effects of ß－sitosterol and other ingredients; Stop or reduce progressive necrosis by recovery of stasis zone in burns wounds; Drainage of necrotic tissues without further injury to residual viable tissues; Prevention and control of wound infection through variation of pathogenic microorganism and reduction in bacterial toxicity on burn wounds and necrotic tissue liquefaction and removal. Precautions 1. Patients suffering larger burn surface areas and developing systemic disease must be treated by the doctors of in the hospital with experiences of MEBT. 2. Repeated squeezing and crashing may soften and thin the ointment, especially in summer, which will not affect its therapeutic efficacy. When it occurs, soak the screwed-tube in boiling water for several minutes and then stand to cool, its dosage form will return to normal. Adverse Effects: No adverse effect has been reported. Direction for Use: For external use only. Directly apply MEBO ointment onto the burn or scald wounds to a thickness less than 1mm every 4-6 hours. Remove the residual ointment and exudation before medicine renewal.The wound should be exposed. For first aid at home (kitchen), immediately apply MEBO on the wounds to relieve pains, arrest bleeding, alleviate injuries and prevent from infection in case of scalds and burns by hot oil or boiling water. The effect is the sooner the better. The consequent treatment of wounds should be conducted according to the following specific cases. For First-degree burns: The clinical signs of first-degree burns include skin redness, slight swelling and pain. Immediate application of MEBO may relieve the pain. The erythema gradually diminishes as MEBO is warmed in situ and absorbed through the skin. At 12h postburn, the skin may return to normal. For burns with edema, the epidermis is partially destroyed, the pains may be relieved more slowly and the wounds would heal in 2~4 days when the superficial stratum corneum exfoliates. 1. I degree burn, skin redness, slight swelling and pain Apply MEBO immediately postburn. With the absorption of MEBO, pain is relieved and edema fades away gradually. Continue applying MEBO. Two to three days later, burned skin would heal. Continue apply MEBO as a protective ointment for about one week so as to fully restore normal skin functions. 2. Treatment for superficial second-degree burns: Apply MEBO directly on wounds in 4 hours postburn. The thickness of medicine should not thicker than 1mm and redress the wounds every 4-6 hours. Clean residues on wounds and exudates with disinfectant gauze before redressing each time. Generally, wounds will cure in 6-7 days. For wounds with blisters, release water in blisters at low position and do not remove the blister skin. Remove the blister skin 3-4 days postburn and continue applying MEBO. Seven days later, wounds wound heal. (1). Apply MEBO with thickness less than 1mm. Release water in blisters at low position and do not remove the blister skin. (2). Three to four days later, remove the blister skin and apply MEBO immediately. Smear MEBO along the direction of fine hair gently to relieve stimulations. (3). Four to six hours after applying MEBO, a layer of white liquefied exudates was formed. It is a normal phenomenon of excreting necrotic skin tissues (Do not take it as infection). (4). Clean the liquefied products with no injury. Redress MEBO with no pains, bleeding or damage to live tissues on wounds. (5). Alternatively, use disinfected gauze to absorb liquefied products for 30 seconds or 1 minute. (6). Disclose gauze along tangential direction. (7). Clean the liquefied products completely. (8). Smear MEBO evenly on wounds. The thickness is less than 1mm. (9). Seven days later, wounds would heal. Apply MEBO as a protective ointment for 7-10 days so as to restore normal skin function. MEBO for Local Burn Wound Treatment Systemic Treatment -- MEBT Video about MEBO for Burn: superficial II Degree Burns Mixed with Deep II Degree Burns (A one and hale-year-old girl was scaled by boiling water with 30% TBSA) Package: 40g per tube, Aluminum-plastic compound tube For external use only. Contraindication Those hypersensitive to sesame oil Storage: Store the ointment in acool place, keep out of reach of children Date of Production: show on outer package Shelf Life: 3 years