Gauze‐based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum

Fraccalvieri, Marco; Fierro, Maria Teresa; Salomone, Marco; Fava, Paolo; Zingarelli, Edoardo; Cavaliere, Giovanni; Bernengo, Maria Grazia; Bruschi, Stefano

doi:10.1111/j.1742-481x.2012.01058.x

Cited by 22 publications

(13 citation statements)

References 25 publications

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“…The rational of the use of sub atmospheric pressure therapy includes: i) increased tissue perfusion; 10 ii) control of the advancing ischemic process; iii) rapid production of a healthy granular wound bed; iv) reduced bacterial load that provides local control of the moisture, exudates and edema besides achieving an important pain relief. 15 …”

Section: Discussionmentioning

confidence: 99%

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

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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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Section: Discussionmentioning

confidence: 99%

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

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“…Fraccalvieri et al . reported four cases of classic PG in which VAC in association with systemic therapy achieved wound healing and a drastic pain reduction . In the VAC technique, a foam dressing covers an acute or chronic wound and a vacuum of 75–125 mmHg is applied, which has the following effects: cleans the wound through the vacuum extraction of tissue remnants; decreases wound size due to retraction of the wound periphery by the vacuum; and improves microcirculation through reduced interstitial edema.…”

Section: Discussionmentioning

confidence: 99%

Recurrent pyoderma gangrenosum after cesarean delivery successfully treated with vacuum‐assisted closure and split thickness skin graft: A case report

Aydın

Uğurlucan

et al. 2014

J of Obstet and Gynaecol

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We describe the case of a 32-year-old woman (gravidity: 4; parity: 2) who underwent cesarean delivery at 37 weeks of gestation and presented with dehiscence and infection of the surgical wound. She had a history of wound infection and dehiscence of the scar from a previous cesarean delivery and dehiscence in the dorsal side of her left hand at the site of intravenous catheterization. The patient was initially diagnosed with a skin infection and later with pyoderma gangrenosum. No evidence of any underlying disease was found. The lesions were treated with systemic corticosteroids and azathioprine, but the lesions were unresponsive to treatment. This complicated case of pyoderma gangrenosum after cesarean delivery, which initially mimicked wound infection, was successfully treated with vacuum-assisted closure and split-thickness skin graft. This synergistic approach with vacuum-assisted closure could be an important treatment option for aggressive and slow-healing lesions.

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“…Also Fraccalvieri et al . [ 8 ] described a good medical result of treatment of pyoderma gangrenosum with a negative pressure device.…”

Section: Discussionmentioning

confidence: 99%

Pyoderma gangrenosum in a patient with common variable primary immunodeficiency

Bergler‐Czop¹,

Brzeźińska-Wcisło²

2013

pdia

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A Ad dd dr re es ss s f fo or r c co or rr re es sp po on nd de en nc ce e: : Beata Bergler-Czop MD, PhD, 2a Lesna St, Case report A b s t r a c tPyoderma gangrenosum is a rare inflammatory skin condition that is associated with systemic inflammatory diseases. It is characterised by the presence of well-secluded, painful ulcerations, often located on the lower limbs. Similarly as in the case of acne inversa, patients' markers of the inflammatory process are elevated; including OB, C-reactive protein and leukocytosis. The aetiology takes into account an over-reactive inflammatory response to various factors (presence of the so-called pathergy symptom). Common variable primary immunodeficiency (CVID) is a disease that is rather often recognized and affects about 1/10,000-100,000 individuals. It is a heterogeneous group of disorders of combined B-and T-cell dysfunction. The case is described of a 22-year-old man with pyoderma gangrenosum that coexisted with CVID. K Ke ey y w wo or rd ds s: : pyoderma gangrenosum, immunodeficiency, inflammation.

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Gauze‐based negative pressure wound therapy: a valid method to manage pyoderma gangrenosum

Cited by 22 publications

References 25 publications

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

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

Recurrent pyoderma gangrenosum after cesarean delivery successfully treated with vacuum‐assisted closure and split thickness skin graft: A case report

Pyoderma gangrenosum in a patient with common variable primary immunodeficiency

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