Applying Intravenous Immunoglobulin and Negative-Pressure Wound Therapy to Treat Refractory Pyoderma Gangrenosum: A Case Report

2020 ◽  
pp. 153473462094045
Author(s):  
Shi-Ying Jin ◽  
Mei Chen ◽  
Feng-Yuan Wang ◽  
Fei Wang
Keyword(s):  
Intravenous Immunoglobulin ◽  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Lower Leg ◽  
Neutrophilic Dermatosis ◽  
Wound Therapy ◽  
Systemic Corticosteroids ◽  
Painful Ulcer ◽  
The Right

Pyoderma gangrenosum (PG) is a rare chronic neutrophilic dermatosis that causes undermining ulcers. Unfortunately, standardization of PG treatment remains a challenge. In this article, we describe a case in which a 69-year-old man presented with a painful ulcer on the right lower leg. The diagnosis of PG was made after excluding other diseases. He had a history of PG on his left lower leg 2 years earlier and was cured by the treatment of systemic corticosteroids and cyclosporin A for 43 days. However, such a treatment was not effective this time. Hence, we applied intravenous immunoglobulin and negative-pressure wound therapy, and the patient was cured. Altogether, this case supports the use of intravenous immunoglobulin as an effective adjuvant for refractory PG, and indicates negative-pressure wound therapy as a treatment option to advance ulcer healing under adequate immunosuppression.

scholarly journals Extensive Refractory Perineal Pyoderma Gangrenosum Treated with Infliximab, Fecal Diversion, and Negative-Pressure Wound Therapy

2019 ◽  
Vol 27 (2) ◽  
pp. 128-131 ◽  
Author(s):  
Mafalda Sousa ◽  
Manuel António Campos ◽  
Ana Cristina Sousa ◽  
Jorge Lopes ◽  
Adélia Rodrigues ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Fecal Diversion ◽  
Wound Therapy

Ulceration of Pyoderma Gangrenosum Treated with Negative Pressure Wound Therapy

2005 ◽  
Vol 95 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Stephen M. Geller ◽  
James A. Longton
Keyword(s):  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Laboratory Tests ◽  
Negative Pressure Wound Therapy ◽  
Chronic Wounds ◽  
Unknown Etiology ◽  
Imaging Studies ◽  
Wound Therapy ◽  
Normal Limits ◽  
Wound Tissue

Pyoderma gangrenosum is a skin disease characterized by wounds with blue-to-purple undermined borders surrounding purulent necrotic bases. This article reports on a patient with a circumferential, full-thickness, and partially necrotic lower-extremity ulceration of unknown etiology. Results of laboratory tests and arterial and venous imaging studies were found to be within normal limits. The diagnosis of pyoderma gangrenosum was made on the basis of the histologic appearance of the wound tissue after biopsy as a diagnosis of exclusion. Negative pressure wound therapy was undertaken, which saved the patient’s leg from amputation. Although negative pressure wound therapy has demonstrated efficacy in the treatment of chronic wounds in a variety of circumstances, this is the first documented use of this technique to treat an ulceration secondary to pyoderma gangrenosum. (J Am Podiatr Med Assoc 95(2): 171–174, 2005)

scholarly journals Gauze-based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum

2012 ◽  
Vol 11 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Marco Fraccalvieri ◽  
Maria Teresa Fierro ◽  
Marco Salomone ◽  
Paolo Fava ◽  
Enrico M Zingarelli ◽  
...  
Keyword(s):  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy ◽  
Valid Method

scholarly journals Negative Pressure Wound Therapy in Pyoderma Gangrenosum Treatment

2020 ◽  
Vol 21 ◽  
Author(s):  
Dariusz Bazaliński ◽  
Anna Karwiec ◽  
Marek Kucharzewski ◽  
Paweł Więch
Keyword(s):  
Pyoderma Gangrenosum ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Wound Therapy

scholarly journals Negative pressure wound therapy as a „bridge” forthe final reconstruction of tissue defect following adegloving injury of the forearm – a case report

2019 ◽  
Vol 6 (3) ◽  
pp. 4-7
Author(s):  
Izabela Ratnicka ◽  
Karolina Kondej ◽  
Justyna Jończyk ◽  
Magdalena Graczyk ◽  
Barbara Chrzanowska ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Subcutaneous Tissue ◽  
Skin Grafting ◽  
Conveyor Belt ◽  
Complex Nature ◽  
Wound Therapy ◽  
Degloving Injury ◽  
The Right ◽  
Degloving Injuries

Degloving injuries are traumatic avulsions usually resulting in large areas of soft tissue defects. The injury involves separation of skin and subcutaneous tissue from fascia and muscles. The complex nature of these injuries requires a patient-oriented multidisciplinary surgical approach and a wide variety of therapeutic options. Negative pressure wound therapy can be of benefit at every stage of the long-lasting treatment. In this paper, we present a case of a 29-year-old male after an occupational accident with a conveyor belt leading to a degloving injury of the right forearm treated in the Department of Plastic Surgery of the Medical University in Gdańsk. The use of NPWT, hyperbaric oxygen therapy, dermal regeneration templates, skin grafting, and early rehabilitation resulted in an excellent functional and aesthetic outcome.

scholarly journals Fasciotomy closure using negative pressure wound therapy in lower leg compartment syndrome

2017 ◽  
Vol 117 (12) ◽  
pp. 710-714 ◽  
Author(s):  
M. Krticka ◽  
D. Ira ◽  
A. Bilik ◽  
P. Rotschein ◽  
J. Svancara
Keyword(s):  
Compartment Syndrome ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Lower Leg ◽  
Wound Therapy

scholarly journals Combination of negative pressure wound therapy and systemic steroid therapy in postsurgical pyoderma gangrenosum after reduction mammoplasty; a case of proven efficacy and safety

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Sara Tanini ◽  
Gianmarco Calugi ◽  
Giulia Lo Russo
Keyword(s):  
Differential Diagnosis ◽  
Pyoderma Gangrenosum ◽  
Steroid Therapy ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Reduction Mammoplasty ◽  
Systemic Steroid ◽  
Wound Therapy ◽  
Aesthetic Result ◽  
Systemic Steroid Therapy

Pyoderma gangrenosum (PG) is a rare non-infective inflammatory disease of unknown etiology characterized by cutaneous papulo-pustoles that rapidly evolve into painful ulcerative lesions. Postoperative PG (PPG) is a clinical variant of PG in which pathergic response occurs at surgical sites. It is important to include PG in the differential diagnosis of breast ulceration. An incorrect diagnosis and treatment can potentially worsen the patient state, causing disfigurement with extensive scarring, an unpleasant aesthetic result and produce consequent psychological trauma. We report a case of PPG after bilateral breast reduction mammoplasty treated with negative pressure wound therapy (NPWT) as local treatment for wound dehiscence in combination with systemic steroid therapy. This synergism led to a good aesthetic result. NPWT improved wound perfusion, it decreased the exudate, and promoted adherence of the mammary gland to the pectoral muscle. After 31 days deep sutures were placed to directly close the wound and the patient was discharged. PPG is a rare, devastating occurrence after surgery. Surgeons must know that PPG is an evenience that can occur in otherwise healthy patients and must be considered in the differential diagnosis in case of necrotic ulcers and apparent infection status. NPWT resulted to have benefits in the treatment of PPG, with a role in limiting the size of the defect, avoiding pathergic self-reaction and allowing a faster recovery with higher chances of achieving a better result.

scholarly journals Useful technique using negative pressure wound therapy on postoperative lower leg open wounds with compartment syndrome

Injury Extra ◽  
2014 ◽  
Vol 45 (9) ◽  
pp. 83-87 ◽  
Author(s):  
Yukichi Zenke ◽  
Koichi Inokuchi ◽  
Hiroyuki Okada ◽  
Kazunori Ooae ◽  
Kentaro Matsui ◽  
...  
Keyword(s):  
Compartment Syndrome ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Lower Leg ◽  
Wound Therapy

Single-use negative pressure wound therapy for the treatment of chronic lower leg wounds

2015 ◽  
Vol 24 (Sup2) ◽  
pp. S4-S9 ◽  
Author(s):  
J.A. Schwartz ◽  
S.G. Goss ◽  
F. Facchin ◽  
C. Gendics ◽  
J.C. Lantis
Keyword(s):  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Lower Leg ◽  
Wound Therapy ◽  
Single Use
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