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We compared surgical debridement to the use of dressings while leaving the epidermis in\u00a0situ (referred to hereon as dressings) in adult patients with TEN. The primary outcome assessed was mortality. The secondary outcome was time to re\u2010epithelialisation. The impact of medications was evaluated. An individual patient data (IPD) systematic review and meta\u2010analysis was undertaken. A random effects meta\u2010analysis and survival analysis for IPD data examined mortality, re\u2010epithelisation time and the effect of systemic medications. The quality of evidence was rated per the Grading of Recommendations Assessment, Development and Evaluation (GRADE). PROSPERO: CRD42021266611 Fifty\u2010four studies involving 227 patients were included in the systematic review and meta\u2010analysis, with a GRADE from very low to moderate. There was no difference in survival in patients who had surgical debridement or dressings (univariate: <jats:italic>p<\/jats:italic>\u2009=\u20090.91, multivariate: <jats:italic>p<\/jats:italic>\u2009=\u20090.31). Patients who received dressings re\u2010epithelialised faster than patients who underwent debridement (multivariate HR: 1.96 [1.09\u20133.51], <jats:italic>p<\/jats:italic>\u2009=\u20090.023). Intravenous immunoglobulin (univariate HR: 0.21 [0.09\u20130.45], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001; multivariate HR: 0.22 [0.09\u20130.53], <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and cyclosporin significantly reduced mortality (univariate HR: 0.09 [0.01\u20130.96], <jats:italic>p<\/jats:italic>\u2009=\u20090.046; multivariate HR: 0.06 [0.01\u20130.73], <jats:italic>p<\/jats:italic>\u2009=\u20090.028) irrespective of the wound care. This study supports the expert consensus of the dermatology hospitalists, that wound care in patients with TEN should be supportive with the epidermis left intact and supported with dressings, which leads to faster re\u2010epithelialisation.<\/jats:p>","DOI":"10.1111\/ajd.14193","type":"journal-article","created":{"date-parts":[[2023,12,8]],"date-time":"2023-12-08T15:01:40Z","timestamp":1702047700000},"page":"128-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["An individual patient data meta\u2010analysis of wound care in patients with toxic epidermal necrolysis"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1208-8182","authenticated-orcid":false,"given":"J. 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