Blyth Moira, Estela Catalina, Young Amber E R
South West Regional Paediatric Burns Unit, United Kingdom.
Burns. 2008 Feb;34(1):98-103. doi: 10.1016/j.burns.2007.02.006. Epub 2007 Jul 17.
Staphylococcal scalded skin syndrome (SSSS) is a rare toxin-mediated condition caused by Staphylococcus aureus, which causes blistering and desquamation of the skin. Between November 2005 and April 2006, four children were admitted to critical care beds in the South West Regional Paediatric Burns Unit because of SSSS affecting more than 50% of the body surface area. Details of these cases are presented, highlighting the potential severity of the condition. The cases also illustrate that fluid overload is a common complication of the condition, despite hypovolaemia being the more obvious risk, and that both hyponatraemia and leukopenia are frequent findings. These summaries clearly demonstrate the need for paediatric critical care in a tertiary burns unit for children with SSSS affecting a large proportion of the body surface area. The cluster of admissions prompted us to write a management protocol for children with severe SSSS and a summary of this is provided. Most children with SSSS will initially present to general paediatric units, where mild cases will be managed, but severe cases should be promptly referred to a tertiary paediatric burns unit for multi-disciplinary care in a critical care environment.
葡萄球菌烫伤样皮肤综合征（SSSS）是一种由金黄色葡萄球菌引起的罕见的毒素介导疾病，可导致皮肤水疱和脱皮。在2005年11月至2006年4月期间，西南地区儿科烧伤病房有4名儿童因SSSS累及超过50%的体表面积而入住重症监护病床。本文介绍了这些病例的详细情况，突出了该病可能的严重程度。这些病例还表明，尽管低血容量是更明显的风险，但液体超负荷是该病常见的并发症，低钠血症和白细胞减少症也很常见。这些总结清楚地表明，对于体表面积大部分受累的SSSS患儿，在三级烧伤病房进行儿科重症监护是必要的。此次集中收治促使我们编写了一份针对重症SSSS患儿的管理方案，并提供了该方案的总结。大多数SSSS患儿最初会就诊于普通儿科病房，轻症病例在那里进行处理，但重症病例应迅速转诊至三级儿科烧伤病房，在重症监护环境中接受多学科治疗。
