A mechanically powered negative pressure device used in conjunction with a bioengineered cell-based product for the treatment of pyoderma gangrenosum: a case report.

Pyoderma gangrenosum (PG), an uncommon inflammatory and ulcerative skin disease, typically is treated medically with a combination of immunosuppression and local wound care, but evidence to guide care is limited. PG wounds can be difficult to heal. A 76-year-old male patient presented with a history...

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Bibliographic Details
Published in:Ostomy Wound Management Vol. 58; no. 9; pp. 44 - 49
Main Authors: Neiderer, Katherine, Martin, Billy, Hoffman, Steven, Jolley, David, Dancho, James
Format: case study pictorial tables/charts Journal Article
Published: HMP Global 2012 Sep
Online Access:View this record in EBSCOhost
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      dt: 2012 Sep
      vid: 58
      iid: 9
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      pub: HMP Global
      place: Malvern, Pennsylvania
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        atl: A mechanically powered negative pressure device used in conjunction with a bioengineered cell-based product for the treatment of pyoderma gangrenosum: a case report.
      aug:
        au:
          Neiderer, Katherine
          Martin, Billy
          Hoffman, Steven
          Jolley, David
          Dancho, James
        affil: Southern Arizona VA Health Care System and University of Arizona, Tucson, AZ 85723, USA. kateneiderer@hotmail.com
      sug:
        subj:
          Negative Pressure Wound Therapy Equipment and Supplies
          Pyoderma Gangrenosum
          Skin, Artificial
          Adrenal Cortex Hormones
          Aged
          Arthritis, Rheumatoid
          Male
          Treatment Outcomes
          Wound Healing
          Aged: 65+ years
          Male
      ab: Pyoderma gangrenosum (PG), an uncommon inflammatory and ulcerative skin disease, typically is treated medically with a combination of immunosuppression and local wound care, but evidence to guide care is limited. PG wounds can be difficult to heal. A 76-year-old male patient presented with a history of rheumatoid arthritis and recalcitrant PG. After 9 months of treatment with local wound care, steroids, and topical tacrolimus, the wound had increased in size from 1.8 cm x 1.5 cm to 7.2 cm x 5.6 cm. At that time, he was started on a regimen of five applications of a bioengineered cell- based product (one application every 2 weeks for a total of five applications) with twice-weekly mechanically powered negative pressure device changes. The latter was started at 75 mm Hg and changed to 125 mm Hg after 4 weeks. Oral corticosteroid therapy was initially started at 40 mg of prednisone, then slowly tapered to 20 mg, but could not be completely discontinued due to a flare in the patient's rheumatoid symptoms. The wound was completely healed after 16 weeks. Research to ascertain the effectiveness of protocols of PG care, including the combination treatment described, is needed to help clinicians provide evidence-based care for these challenging wounds.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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