Paediatric outcomes of staphylococcal scalded skin syndrome, Stevens-Johnson syndrome and toxic epidermal necrolysis – a 10 year review

Deborah Maze1, Mitchell Nash2, Andrew Holland3, John Harvey4
1 The Burns Unit & the Children’s Hospital at Westmead Burns Research Institute
The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145 deborah.maze@health.nsw.gov.au

2 The Burns Unit & the Children’s Hospital at Westmead Burns Research Institute
The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145 mitchellnash@gmail.com

3 The Burns Unit & the Children’s Hospital at Westmead Burns Research Institute
The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145 andrew.holland@health.nsw.gov.au

4 The Burns Unit & the Children’s Hospital at Westmead Burns Research Institute
The Children’s Hospital at Westmead, Locked Bag 4001, Westmead, Sydney, NSW 2145 john.harvey@health.nsw.gov.au

Aims: The Burns Unit at the Children’s Hospital at Westmead (CHW) provides treatment for patients with major skin loss resulting from Staphylococcal Scalded Skin Syndrome (SSSS), Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN).

Although patients with non-burn major skin loss are small in number in comparison to acute burn injury admissions, they can pose a major wound management challenge.

There appears currently limited data reporting the paediatric outcomes of SSSS, SJS and TEN. This study aims to identify cases treated at CHW and report on our experience with the clinical management and outcomes of the group.

Methods: A retrospective review was conducted looking at the total number of patients diagnosed with SSSS, SJS or TEN during a 10 year period 2006 – 2015 inclusive. The study was approved by our institution’s ethics committee.

Results: 86 patients were identified (46 SSSS, 34 SJS and 6 TEN)
Data presented will include length of stay, intensive care bed days, pain management, wound management, time to re-epithelialisation, enteral nutrition requirements, patient survival and long term sequelae. Outcomes will be compared in relation to the total body surface area of skin loss. Involvement of the CHW Burns Service in this patient group will also be discussed.
A multidisciplinary team approach to the management of patients with SSSS, SJS & TEN is essential, including access to appropriate wound management expertise. Burn Units are ideally suited to treat paediatric patients with major skin loss conditions, and should be consulted in a timely manner following admission.

Key Words
Paediatric, Staphylococcal Scalded Skin Syndrome, Stevens-Johnson Syndrome, Toxic Epidermal Necrolysis, wound management, outcomes

Biography

Deborah is the Clinical Nurse Consultant for Paediatric Burns at the Children’s Hospital at Westmead. The clinical focus of her current role is to coordinate all aspects of management for paediatric inpatients with a burn injury. This includes clinical care in the Burns Unit, PICU, ED and Operating Theatres.Deborah has held various nursing roles within the Burns service over the past 20yrs. She has developed a special interest in paediatric burn wound management and pain management.Deborah is active in all areas of burns education, research and prevention, a long standing member of ANZBA and is an EMSB coordinator.

About ANZBA

ANZBA is a not for profit organisation and the peak body for health professionals responsible for the care of the burn injured in Australia and New Zealand. ANZBA encourages higher standards of care through education, performance monitoring and research.

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