Nutritional Support and Metabolic Regulation
Patients suffering from extensive skin detachment enter a hypermetabolic state characterized by high energy expenditure and rapid protein breakdown.
This metabolic demand is similar to that of a major burn or severe trauma. Providing adequate nutrition is essential to support the immune system and promote the healing of vast areas of skin and mucosa. Whenever possible, enteral nutrition—delivered via a nasogastric or nasojejunal tube—is preferred over intravenous nutrition. Enteral feeding helps maintain the integrity of the gut lining and reduces the risk of bacterial translocation and subsequent sepsis.
The caloric and protein requirements are significantly elevated. High-protein formulas are often used to offset the nitrogen loss occurring through the denuded skin. Regular monitoring of glucose levels is also necessary, as the stress of the illness and the use of certain medications like corticosteroids can lead to hyperglycemia. In patients with severe oral and esophageal involvement, the placement of a feeding tube must be done with extreme care to avoid damaging the fragile mucosal linings. Nutritional support is not just a secondary concern but a primary treatment modality that directly influences the speed of recovery and the body's ability to resist infection.