Postoperative Pyoderma Gangrenosum After Thoracolumbar Spinal Fusion with Instrumentation

Bellamy, J; Ananthakrishnan, Dheera

doi:10.2106/jbjs.cc.21.00461

Cited by 3 publications

(3 citation statements)

References 19 publications

(28 reference statements)

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“…Our review and the described case also show that even if lower extremities are the most common site for PG lesions, the disease can also affect other regions, even at a distance from the surgical incision [19,23,26,27,31]. In the reviewed cases coexistent inflammatory bowel disease was prevalent, which is consistent with findings from unselected patient groups [26,30,36].…”

supporting

confidence: 86%

“…Hence this type of treatment even deteriorates the course of PG. Other authors, as we also do, highlight the need to actively seek PG in the case of sterile wound healing complications [7,19,[21][22][23][24][25][26][27][28][29][30][31][32][33][35][36][37][38][39]. Glucocorticosteroids were the most commonly used immunosuppressive, effective part of the regimens for postoperative PG treatment [17][18][19][20][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39].…”

mentioning

confidence: 99%

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An aggressive course of pyoderma gangrenosum mimicking bacterial osteomyelitis after open reduction and internal fixation of a distal radius fracture with a titanium plate

Wasiak¹,

Ciszek²,

Babiak³

et al. 2022

Reumatologia

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Pyoderma gangrenosum (PG) is a rare condition characterized by the development of aseptic, non-healing skin ulcers. Any skin trauma, such as a surgical incision, can trigger an outbreak of lesions. Our case and literature review show that a physician should consider PG in every event of a non-healing, aseptic wound after surgery. The treatment of PG requires collaboration within a multidisciplinary team and immunosuppressive therapy is the first line of treatment, while surgical interventions should be avoided in the active stage of PG.

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supporting

confidence: 86%

mentioning

confidence: 99%

An aggressive course of pyoderma gangrenosum mimicking bacterial osteomyelitis after open reduction and internal fixation of a distal radius fracture with a titanium plate

Wasiak¹,

Ciszek²,

Babiak³

et al. 2022

Reumatologia

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show abstract

“…However, split skin graft failure was still observed. 98 Furthermore, the use of dermal regeneration templates, 19,101 human cryopreserved placental membrane, 102 and structural placental allograft 81,102 were reported. However, large-scale studies are needed to evaluate their efficacy in the management of PSPG.…”

Section: Discussionmentioning

confidence: 99%

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Guliyeva,

Janis

2024

Plastic and Reconstructive Surgery - Global Open

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Summary: Pyoderma gangrenosum is a neutrophilic dermatosis characterized by immune dysfunction and pathergy. Thus, it is frequently seen in patients with underlying systemic illnesses or postoperatively. For the performance of the debridement or closure of the resultant defect, plastic surgeons are often involved in the care of pyoderma patients. However, both procedures may exacerbate the injury. Therefore, plastic surgeons must be familiar with the presentation of postsurgical pyoderma to avoid further damage and safely repair related soft tissue defects. A systematic search of the PubMed/Medline database was performed using the following keywords: “pyoderma gangrenosum” and “surgery.” This online database search has identified 656 studies published between 1958 and 2022. Only reconstructed cases of postsurgical pyoderma gangrenosum were selected. Twenty-eight patients who developed pyoderma after dermatologic, plastic, orthopedic, cardiovascular, general, or obstetric surgery were included in this study. The average time to the PG presentation and diagnosis was 5.5 and 17 days, respectively. Diagnostic scoring tools were not used, and the diagnosis was primarily based on histopathology after repeated treatment failures. The patients received split- or full-thickness skin grafts, local, pedicled, and free flaps. An estimated 82.1% underwent skin grafting, whereas 42.9% underwent flap reconstruction. In addition, 21.4% got both the graft and flap. Accurate diagnosis of PSPG, prevention of further surgical injury, and timely medical management are vital for improving patient outcomes. Reconstruction can be performed, if required. However, despite the availability of different reconstructive techniques, there is no standard approach to the management of the PSPG.

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Dapsone/heparin

2022

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Postoperative Pyoderma Gangrenosum After Thoracolumbar Spinal Fusion with Instrumentation

Cited by 3 publications

References 19 publications

An aggressive course of pyoderma gangrenosum mimicking bacterial osteomyelitis after open reduction and internal fixation of a distal radius fracture with a titanium plate

An aggressive course of pyoderma gangrenosum mimicking bacterial osteomyelitis after open reduction and internal fixation of a distal radius fracture with a titanium plate

Postsurgical Pyoderma Gangrenosum Requiring Plastic Surgical Intervention: A Practical Review

Dapsone/heparin

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