A survey into toxic shock syndrome (TSS) in UK burns units

Toxic shock syndrome (TSS) is a rare complication of a Staphylococcus aureu s infection and is primarily seen in children with small burns. The true in cidence of TSS in burns patients is not known and the number of presumptive cases rarely reported. This survey was undertaken to determine if the inci dence of TSS in children with burns could be related to the type of dressin g used to cover the wound. A questionnaire was compiled and sent to the Sen ior Nurse in charge of each of the UK burns units. General information on t he number of admissions, age of the patient, cause of injury and burn wound management was sought. An 81% response was obtained after two mailshots and follow up telephone ca lls. Seventy percent (23/33) of units which answered the survey nursed children. Of these, eight units had either not encountered TSS previously or not had a case within the past two years. These units were small, admitting a maxi mum of 50 patients each year. Of the units where TSS was encountered, appro ximately 2.5% of children admitted showed symptoms of TSS. Of the units who nursed both adults and children, seven units had seen TSS in burned adult patients which has not been reported in the literature. Of the eight units where TSS had not been recently encountered, four routinely administered pr ophylactic antibiotics to prevent infection whereas routine administration of antibiotics occurred in only two of the 15 units where TSS was seen. Alt hough wound management procedures differed slightly there were many similar ities. These included wound cleaning with normal saline, covering with eith er silver sulphadiazine (1%) or povidone iodine (10%), depending upon the i nfection status, and dressing with a paraffin tulle, gauze and crepe bandag es. No association between the management of the burn wound and subsequent deve lopment of TSS could be established. (C) 2000 Elsevier Science Ltd and ISBI . All rights reserved.