The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: A systematic review and personal experience.

Pyoderma gangrenosum (PG) is a rare painful ulcerative neutrophilic inflammatory skin disease, necessitating a high level of diagnostic suspicion associated with appropriate treatment to avoid progression. Negative pressure wound therapy (NPWT) has been efficiently used in the treatment of different...

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Publicado en:Wound Repair & Regeneration Vol. 29; no. 3; pp. 486 - 495
Autores principales: Almeida, Ivan R., Coltro, Pedro S., Gonçalves, Henrique O. C., Westin, Andrezza T., Almeida, Juliano B., Lima, Renan V. K. S., Silva, Marcelo F., Farina Junior, Jayme A.
Formato: case study pictorial research systematic review tables/charts Journal Article
Publicado: Wiley-Blackwell May2021
Acceso en línea:Ver este registro en EBSCOhost
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        atl: The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: A systematic review and personal experience.
      aug:
        au:
          Almeida, Ivan R.
          Coltro, Pedro S.
          Gonçalves, Henrique O. C.
          Westin, Andrezza T.
          Almeida, Juliano B.
          Lima, Renan V. K. S.
          Silva, Marcelo F.
          Farina Junior, Jayme A.
        affil: Division of Plastic Surgery, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
      sug:
        subj:
          Pyoderma Gangrenosum Therapy
          Negative Pressure Wound Therapy
          Treatment Outcomes
          Wound Healing
          Human
          Systematic Review
          Adult
          Female
          Pyoderma Gangrenosum Drug Therapy
          Immunosuppressive Agents Therapeutic Use
          Pyoderma Gangrenosum Surgery
          Surgical Flaps
          Combined Modality Therapy
          PubMed
          Medline
          Cochrane Library
          Adult: 19-44 years
          Female
      ab: Pyoderma gangrenosum (PG) is a rare painful ulcerative neutrophilic inflammatory skin disease, necessitating a high level of diagnostic suspicion associated with appropriate treatment to avoid progression. Negative pressure wound therapy (NPWT) has been efficiently used in the treatment of different types of wounds. However, the role of NPWT in the management of PG is still controversial, due to the risk of the pathergy phenomenon. In this article, we conducted a systematic review (according to the PRISMA guidelines) on the use of NPWT in the treatment of PG, and we report our personal experience with two patients treated with this device. The result of the review showed that articles on the topic are, in their entirety, of low levels of evidence, such as case series, case reports, and reviews. Improvement in wound healing with the use of NPWT was observed in 85.1% of the patients studied. Besides, a significant association between improvement in wound healing with NPWT and immunosuppressive therapy was observed. Regarding the cases reported here, both showed good outcomes with the use of NPWT and skin graft during the treatment of PG injuries. Due to the rarity of PG, there is a scarcity of studies with robust evidence for standardization and comparison between treatments, which consequently makes it difficult to select therapeutic options. However, based on this systematic review and reported cases, we consider NPWT a safe option for adjuvant treatment of wounds caused by PG if combined with systemic immunosuppression, which plays a key role in greater chances of successful treatment. This approach should be recommended, whenever possible, associated with skin grafting to accelerate wound closure. The role of negative pressure wound therapy (NPWT) on the treatment of pyoderma gangrenosum: a systematic review and personal experience.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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