A Wound Care Specialist's Approach to Pyoderma Gangrenosum.
Significance: Pyoderma gangrenosum (PG) is a rare neutrophilic ulcerative dermatosis that poses a high burden of morbidity due to underdiagnosis, resistance to therapy, and limited therapeutic options. Optimization of wound care strategies and multimodal anti-inflammatory approaches are necessary to...
| Publicado en: | Advances in Wound Care (2162-1918) Vol. 9; no. 12; pp. 686 - 695 |
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| Autores principales: | , , , , |
| Formato: | algorithm tables/charts Journal Article |
| Publicado: |
Mary Ann Liebert, Inc.
Dec2020
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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=146737550&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 146737550 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 21621918 EGZ0 jtl: Advances in Wound Care (2162-1918) issn: 21621918 maglogo: N pubinfo: dt: Dec2020 vid: 9 iid: 12 pid: 1365 pub: Mary Ann Liebert, Inc. place: New Rochelle, New York artinfo: ui: 146737550 146737550 146737550 10.1089/wound.2020.1168 146737550 ppf: 686 ppct: 9 formats: tig: atl: A Wound Care Specialist's Approach to Pyoderma Gangrenosum. aug: au: Croitoru, David Naderi-Azad, Sheida Sachdeva, Muskaan Piguet, Vincent Alavi, Afsaneh affil: Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. sug: subj: Pyoderma Gangrenosum Pathology Wound Care Bandages and Dressings Antiinfective Agents Paradigms Compression Therapy Debridement ab: Significance: Pyoderma gangrenosum (PG) is a rare neutrophilic ulcerative dermatosis that poses a high burden of morbidity due to underdiagnosis, resistance to therapy, and limited therapeutic options. Optimization of wound care strategies and multimodal anti-inflammatory approaches are necessary to mitigate multiple converging pathways of inflammation leading to delayed healing, which is further complicated by additional factors such as pathergy. Recent Advances: PG treatment typically involves reducing inflammation, controlling pain, promoting wound healing, and treating the underlying etiology. Recent advances have been made with regard to targeted therapies for PG with topical, intralesional, and systemic medications. Wound management includes gentle cleansing without sharp debridement, limited topical antibacterial use, and maintenance of a moist environment to promote epithelial migration. Critical Issues: Wound dressings and compression therapy, in particular, introduce a wide variety of therapeutic options. Dressings should aim to target the specific PG wound type, depending on the depth and exudative nature of the wound, as well as local secondary factors. Superficial wounds, eschar, exudative wounds, granulating wounds, and colonized wounds are managed with variable approaches to the same underlying principles of pathergy avoidance, moisture balance, and reduction of immunogenic inflammatory stimuli. The importance of compression therapy to decrease edema and overgranulation fits within this treatment paradigm. Future Directions: As each of these treatment modalities offers a complex mixture of advantages and limitations, development of a systematic treatment algorithm in the future can help direct a more tailored path toward wound healing. pubtype: Academic Journal doctype: algorithm tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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