Steven Johnson Syndrome/Toxic Epidermal Necrolysis Management in the Pediatric Population: The Surgeon’s Perspective
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Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis are rare, life-threatening cutaneous reactions resulting in epidermal detachment that is likened to partial thickness burns. There are sparse data with regards to wound management in the pediatric literature. We aimed to explore the current practices of pediatric-only burn centers in the Pediatric Injury Quality Improvement Collaborative to lay the framework for a standardized approach to wound care.
A 36-item survey was administered to pediatric surgeons at participating centers of the consortium. No patient specific data was collected.
Surveys were completed from 4 out of the 5 institutions. The admitting service differed amongst all centers with patients being admitted to the burn team, critical care, general pediatrics, and infectious disease. The burn team primarily managed wounds (n=4) with one institution partnering with dermatology. Complete debridement occurred at one institution, gentle cleansing at two, and no debridement at one institution. Burn consults are obtained at least within 24 hours for all but one institution, where the threshold is TBSA >10%. Most dressing changes are performed daily (n=3) by the burn nurses (n=4). Enteral feeding is initiated within 24 hours universally. All institutions use antibiotic ointment and occlusive gauze as a primary dressing.
SJS/TEN is a rare but serious disease process in children with variations in practices and limited data on best management protocols. Further details into specific management protocols and outcomes may provide insight into best practice guidelines.
When and Where Presented
Presented at the 21st Congress of the International Society for Burn Injuries; Guadalajara, Mexico; August 28-September 1, 2022.
Stewart, Shai MD; Fraser, James; Kearse, Ladonna; and Aguayo, Pablo, "Steven Johnson Syndrome/Toxic Epidermal Necrolysis Management in the Pediatric Population: The Surgeon’s Perspective" (2022). Presentations. 74.