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A Step Forward in Treatment

David M. Heimbach, MD; Loren H. Engrav, MD; Janet A. Marvin, RN, MN; Timothy J. Harnar, MD; Baiba J. Grube, MD

JAMA. 1987;257(16):2171-2175.

Abstract
Toxic epidermal necrolysis is an uncommon but severe form of epidermal sloughing with associated mucositis. Treated in a general hospital, it carries a high mortality (25% to 70%) and substantial long-term morbidity. If the patient is referred early to a burn center, where it can be treated with biologic dressings and intensive support care, the mortality can be reduced below 20% and there may be negligible long-term morbidity. We describe 19 patients so treated, with three deaths and no long-term complications.

(JAMA 1987;257:2171-2175)

Author Affiliations
From the Burn Center, Department of Surgery, University of Washington, Seattle. Dr Harnar is now with Texas Tech University, Lubbock.

Footnotes
Reprint requests to the Department of Surgery, Harborview Medical Center, 325 Ninth Ave, Seattle, WA 98104 (Dr Heimbach).

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