The surgical approach to Pyoderma gangrenosum: A retrospective monocenter study.

Pyoderma gangrenosum is a diagnosis of exclusion. It occurs rarely and is frequently misdiagnosed. It can result in severe tissue loss, particularly in surgical units with little experience. Nevertheless, surgical treatment might be necessary for reconstruction, once the progression of these wounds...

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Publicado en:Wound Repair & Regeneration Vol. 29; no. 3; pp. 478 - 486
Autores principales: Bingoel, Alperen S., Krezdorn, Nicco, Kaltenborn, Alexander, Dastagir, Khaled, Jokuszies, Andreas, Mett, Tobias R., Vogt, Peter M.
Formato: algorithm pictorial research tables/charts Journal Article
Publicado: Wiley-Blackwell May2021
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: The surgical approach to Pyoderma gangrenosum: A retrospective monocenter study.
      aug:
        au:
          Bingoel, Alperen S.
          Krezdorn, Nicco
          Kaltenborn, Alexander
          Dastagir, Khaled
          Jokuszies, Andreas
          Mett, Tobias R.
          Vogt, Peter M.
        affil: Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Burn Center, Hannover Medical School, Hannover, Germany
      sug:
        subj:
          Pyoderma Gangrenosum Surgery
          Wound Care
          Treatment Outcomes
          Human
          Retrospective Design
          Germany
          Descriptive Statistics
          Surgical Debridement
          Necrosis Surgery
          Allografts Utilization
          Negative Pressure Wound Therapy
          Surgical Flaps Utilization
          Wound Healing
          Surgery, Reconstructive
      ab: Pyoderma gangrenosum is a diagnosis of exclusion. It occurs rarely and is frequently misdiagnosed. It can result in severe tissue loss, particularly in surgical units with little experience. Nevertheless, surgical treatment might be necessary for reconstruction, once the progression of these wounds is controlled. We aimed to characterize medical findings in Pyoderma patients with extensive defects to assess the surgical procedures and their outcome. A retrospective study was conducted at our centre over an 18‐year period. Inclusion criteria were the diagnosis of Pyoderma gangrenosum and at least one surgical intervention. Descriptive statistics were used to analyse the data. Sixteen patients were included. The mean size of the lesions was noted with 12 × 8 cm. Surgical procedures comprised debridements/necrectomies, allograft conditioning, negative pressure wound therapy, skin grafts, and microvascular free flaps. Seven patients were discharged with healed wounds, six with minor wound healing disturbances. Three patients succumbed to their underlying diseases. Drug‐based therapy can stop the progress of Pyoderma, but severe tissue loss can be a persistent problem. According to our data, reconstructive‐surgical treatments (debridement, autologous and allogenous skin transplantation and microvascular free flaps) act as an integral component of the therapy and can be safe options for selected patients. Furthermore, we provide an algorithm that we follow at our department in severe cases.
      pubtype: Academic Journal
      doctype:
        algorithm
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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