Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review.
Chronic painful ulcers caused by pyoderma gangrenosum (PG) and cutaneous vasculitis remain to be a therapeutic challenge. Skin grafts have been used with success in selected cases but are generally avoided due to the fear of pathergy. The aim of this study was to investigate the safety and efficacy...
| Published in: | Wound Repair & Regeneration Vol. 29; no. 2; pp. 240 - 254 |
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| Main Authors: | , , |
| Format: | research systematic review tables/charts Journal Article |
| Published: |
Wiley-Blackwell
Mar2021
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=149077396&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 149077396 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10671927 DPV jtl: Wound Repair & Regeneration issn: 10671927 maglogo: Y pubinfo: dt: Mar2021 vid: 29 iid: 2 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 149077396 147819060 149077396 149077396 10.1111/wrr.12882 149077396 ppf: 240 ppct: 14 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Efficacy and safety of skin grafting in treatment of vasculitic ulcer and pyoderma gangrenosum—A systematic review. aug: au: Morgenstjerne‐Schwenck, Liv E. T. Knudsen, Jane T. Prasad, Sumangali C. affil: Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark sug: subj: Skin Transplantation Methods Vasculitis Surgery Skin Ulcer Surgery Pyoderma Gangrenosum Surgery Treatment Outcomes Evaluation Skin Transplantation Adverse Effects Human Systematic Review Medline Embase Cochrane Library Descriptive Statistics Surgical Patients Confidence Intervals Wound Healing Transplant Donor Site Wound Care Methods Preoperative Care Postoperative Care Immunosuppressive Agents Administration and Dosage ab: Chronic painful ulcers caused by pyoderma gangrenosum (PG) and cutaneous vasculitis remain to be a therapeutic challenge. Skin grafts have been used with success in selected cases but are generally avoided due to the fear of pathergy. The aim of this study was to investigate the safety and efficacy of skin grafting in the treatment of primary vasculitic ulcer (PVU) and PG. MEDLINE, Embase, the Cochrane Library, Clinicaltrial.gov, and WHO International Clinical Trials Registry Platform (ICTRP) were searched from inception to March 2020. A search for grey literature was conducted in May 2020. We included studies assessing the efficacy and safety of skin grafting in the treatment of PG and PVU. Studies were only included if skin grafting was performed after establishment of PG or PVU diagnosis. A total of 721 articles was identified through the database search of which 92 were included in this study. Ten articles were identified by handsearching the reference list of included studies. Finally, 102 articles describing 212 wounds in 153 patients were included. Complete healing was found in 75.5% of the wounds. The average time to complete was 10.8 weeks (95% CI 6.1‐15.6). The mean donor site healing time was 1.9 weeks (95% CI 0.52‐3.20). Pathergy was reported in 8 (5.2%) patients. One patient had severe infection related to skin grafting. A statistically significant difference in the number of patients receiving preoperative (P =.0079) and postoperative (P =.002) immunosuppressive therapy was found between the groups with complete healing/reduction and no improvement/aggravation. This systematic review finds the current evidence on efficacy and safety of skin grafting in treatment of PG and PVU to be promising but limited to the size and lack of studies superior to case reports and case series. Future placebo‐controlled trials are required to draw a stronger conclusion. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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