scholarly journals Non-surgical Management of Complex Refractory Pyoderma Gangrenosum With Negative Pressure Wound Therapy With Instillation

Cureus ◽  
2021 ◽  
Author(s):  
Frank G Lee ◽  
Ethan Song ◽  
Sean J Wallace ◽  
Thomas J Shaughnessy ◽  
Mamtha Raj ◽  
...  
Author(s):  
Shi-Ying Jin ◽  
Mei Chen ◽  
Feng-Yuan Wang ◽  
Fei Wang

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.


2019 ◽  
Vol 27 (2) ◽  
pp. 128-131 ◽  
Author(s):  
Mafalda Sousa ◽  
Manuel António Campos ◽  
Ana Cristina Sousa ◽  
Jorge Lopes ◽  
Adélia Rodrigues ◽  
...  

2005 ◽  
Vol 95 (2) ◽  
pp. 171-174 ◽  
Author(s):  
Stephen M. Geller ◽  
James A. Longton

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)


2012 ◽  
Vol 11 (2) ◽  
pp. 164-168 ◽  
Author(s):  
Marco Fraccalvieri ◽  
Maria Teresa Fierro ◽  
Marco Salomone ◽  
Paolo Fava ◽  
Enrico M Zingarelli ◽  
...  

2020 ◽  
Vol 21 ◽  
Author(s):  
Dariusz Bazaliński ◽  
Anna Karwiec ◽  
Marek Kucharzewski ◽  
Paweł Więch

2017 ◽  
Vol 9 (2) ◽  
Author(s):  
Sara Tanini ◽  
Gianmarco Calugi ◽  
Giulia Lo Russo

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.


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