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Society of Dermatology Hospitalists supportive care guidelines for the management of Stevens-Johnson syndrome/toxic epidermal necrolysis in adults.
Journal of the American Academy of Dermatology ( IF 12.8 ) Pub Date : 2020-03-07 , DOI: 10.1016/j.jaad.2020.02.066
Lucia Seminario-Vidal 1 , Daniela Kroshinsky 2 , Stephen J Malachowski 3 , James Sun 4 , Alina Markova 5 , Thomas M Beachkofsky 6 , Benjamin H Kaffenberger 7 , Elizabeth N Ergen 8 , Melissa Mauskar 9 , Alina Bridges 10 , Cody Calhoun 7 , Adela R Cardones 11 , Steven T Chen 2 , James Chodosh 12 , Jonathan Cotliar 13 , Mark D P Davis 10 , Katherine L DeNiro 14 , Arturo R Dominguez 15 , Juliana Eljure-Téllez 16 , Alisa Femia 17 , Lindy P Fox 18 , Anisha Guda 19 , Caroline Mitchell 20 , Arash Mostaghimi 21 , Alex G Ortega-Loayza 22 , Cindy Owen 23 , Helena Pasieka 24 , Sahand Rahnama-Moghadam 25 , Hajirah N Saeed 12 , Rebecca B Saunderson 26 , Swapna Shanbhag 27 , Victoria R Sharon 28 , Lindsay Strowd 29 , Samantha Venkatesh 30 , Karolyn A Wanat 31 , David A Wetter 10 , Scott Worswick 32 , Robert G Micheletti 33
Affiliation  

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are life-threatening conditions with high morbidity and mortality. Supportive care management of SJS/TEN is highly variable. A systematic review of the literature was performed by dermatologists, ophthalmologists, intensivists, and gynecologists with expertise in SJS/TEN to generate statements for supportive care guideline development. Members of the Society of Dermatology Hospitalists with expertise in SJS/TEN were invited to participate in a modified, online Delphi-consensus. Participants were administered 9-point Likert scale questionnaires regarding 135 statements. The RAND/UCLA Appropriateness Method was used to evaluate and select proposed statements for guideline inclusion; statements with median ratings of 6.5 to 9 and a disagreement index of ≤1 were included in the guideline. For the final round, the guidelines were appraised by all of the participants. Included are an evidence-based discussion and recommendations for hospital setting and care team, wound care, ocular care, oral care, urogenital care, pain management, infection surveillance, fluid and electrolyte management, nutrition and stress ulcer prophylaxis, airway management, and anticoagulation in adult patients with SJS/TEN.

中文翻译:

皮肤科协会住院医师对成人史蒂文斯-约翰逊综合征/中毒性表皮坏死溶解的支持性护理指南。

史蒂文斯-约翰逊综合症(SJS)和中毒性表皮坏死溶解症(TEN)是威胁生命的疾病,发病率和死亡率很高。SJS / TEN的支持性护理管理变化很大。由具有SJS / TEN专门知识的皮肤科医生,眼科医生,强化科医生和妇科医生对文献进行了系统的回顾,以产生支持治疗指南制定的说明。皮肤科住院医师学会的会员,他们具有SJS / TEN的专业知识,应邀参加了经过修改的在线Delphi共识。参与者接受了有关135项陈述的9点李克特量表问卷调查。RAND / UCLA适当性方法用于评估和选择建议的陈述以纳入指南;中位数为6的陈述。指南中包含5到9,意见分歧指数≤1。对于最后一轮,所有参与者都对指南进行了评估。其中包括针对医院设置和护理团队,伤口护理,眼部护理,口腔护理,泌尿生殖系统护理,疼痛管理,感染监测,液体和电解质管理,营养和应激性溃疡预防,气道管理和抗凝的基于证据的讨论和建议在成年SJS / TEN患者中。
更新日期:2020-03-07
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