A novel approach to the management of pyoderma gangrenosum complicating reduction mammaplasty.
Reduction mammaplasty is a common procedure performed by plastic and reconstructive surgeons to relieve chronic back and neck pain associated with macromastia, with the added benefit of an improvement in the aesthetic contour of the ptotic breast. Complications related to this procedure are fortunat...
| Publicado en: | Aesthetic Surgery Journal Vol. 30; no. 2; pp. 186 - 194 |
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| Autores principales: | , , , , , |
| Formato: | case study Journal Article |
| Publicado: |
Oxford University Press / USA
Mar2010
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105192634&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105192634 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1090820X 1XDY jtl: Aesthetic Surgery Journal issn: 1090820X maglogo: N pubinfo: dt: Mar2010 vid: 30 iid: 2 pid: 622 pub: Oxford University Press / USA artinfo: ui: 105192634 NLM20442095 2010646380 10.1177/1090820X10366011 NLM20442095 105192634 ppf: 186 ppct: 8 formats: tig: atl: A novel approach to the management of pyoderma gangrenosum complicating reduction mammaplasty. aug: au: Goshtasby PH Chami RG Johnson RM Goshtasby, Parviz H Chami, Robert G Johnson, R Michael affil: Division of Plastic and Reconstructive Surgery, Department of Surgery, Wright State University-Boonshoft School of Medicine, Dayton, OH 45409, USA sug: subj: Breast Reconstruction Postoperative Complications Therapy Pyoderma Gangrenosum Therapy Bandages and Dressings Chondroitin Sulfates Therapeutic Use Collagen Therapeutic Use Debridement Female Immunosuppressive Agents Therapeutic Use Middle Age Postoperative Pain Therapy Skin Transplantation Middle Aged: 45-64 years Female ab: Reduction mammaplasty is a common procedure performed by plastic and reconstructive surgeons to relieve chronic back and neck pain associated with macromastia, with the added benefit of an improvement in the aesthetic contour of the ptotic breast. Complications related to this procedure are fortunately uncommon, but include hematoma, infection, and wound breakdown. The authors report an interesting case of reduction mammaplasty complicated postoperatively by pyoderma gangrenosum (PG), which is a rare inflammatory disorder leading to progressive skin necrosis. The destructive process, which involved both breast incisions, was managed successfully with immunosuppressive therapy and intensive wound care, followed by a novel method of coverage with a dermal regeneration template and subsequent epidermal autograft that led to stable coverage of the open wounds. PG is frequently misdiagnosed as a necrotizing infection, leading to improper debridement with exacerbation of the disease process. The mainstay of therapy for PG is still nonoperative and focuses on immunosuppressive medications and local wound care, which allows healing in most cases. However, there are a few indications for surgical intervention, including significantly large wounds that are refractory to medical management. It is important for plastic surgeons and other clinicians to be cognizant of this entity, as a delay in diagnosis and management of PG can lead to serious consequences, with considerable soft tissue loss and disfigurement of the breast. pubtype: Academic Journal doctype: case study Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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