Benefits of the use of porcine skin for the management of toxic epidermal necrolysis injuries: Review of the literature

• The use of porcine skin as a dressing in the management of toxic epidermal necrolysis favors rapid re-epithelialization and serves as a means of protection against possible infections. • The use of porcine skin has been shown to reduce the volume of intravenous fluids and provides better pain control for patients, reduceding the need for powerful analgesics. • The average re-epithelialization time was 14.2 days with the use of porcine skin. It has been previously described that with the use of traditional, silver or biosynthetic dressings, the re-epithelialization time ranges from 14.16 +/- 9.42 days and only with xenograft the time is 12.4 days. Toxic epidermal necrolysis (TEN) is a rare immune-mediated adverse skin reaction; secondary in most cases to the administration of a drug. Due to its high mortality, immediate diagnosis and management in an intensive care unit is essential. In addition, temporary coverage of skin lesions should be performed to avoid fluid loss, reduce pain and prevent infection. An alternative for this is the use of porcine skin, which has been shown to have good aesthetic results in the management of TEN. To demonstrate the benefits provided by the use of porcine skin as a biological dressing in TEN injuries in the Plastic, Reconstructive and Burn Surgery service of the Arzobispo Loayza National Hospital. Descriptive, retrospective study of TEN cases referred to our service from 2016 to 2020 where 9 patients were found, with dermal involvement >30 % of total body surface area (TBSA) and who underwent porcine skin as a biological dressing. The most frequent identifiable cause of TEN was the use of antibiotics. The mortality was 33 %. Total epithelialization of the lesions was obtained in 7 of the 9 patients (77 %) and the mean epithelialization time was 14.2 days. The use of the porcine skin dressing is effective in patients with TEN and favors its re-epithelialization.