Pyoderma gangrenosum and dehydrated human amnion/chorion membrane: a potential tool for an orphan disease.

Objective: Pyoderma gangrenosum (PG) is an often-misdiagnosed, painful, inflammatory and ulcerative skin disorder. It is an orphan disease, where standard wound treatments such as sharp surgical debridement are contraindicated. This retrospective case series sought to evaluate the application of deh...

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Publicado en:Journal of Wound Care Vol. 31; no. 10; pp. 808 - 815
Autores principales: Alston, Dylan, Eggiman, Evan, Forsyth, R Allyn, Tettelbach, William H
Formato: case study pictorial research tables/charts Journal Article
Publicado: Mark Allen Holdings Limited Oct2022
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2022
      vid: 31
      iid: 10
      pid: 11383
      pub: Mark Allen Holdings Limited
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        10.12968/jowc.2022.31.10.808
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        atl: Pyoderma gangrenosum and dehydrated human amnion/chorion membrane: a potential tool for an orphan disease.
      aug:
        au:
          Alston, Dylan
          Eggiman, Evan
          Forsyth, R Allyn
          Tettelbach, William H
        affil: Intermountain Southridge Clinic Dermatology, Riverton, UT, US
      sug:
        subj:
          Pyoderma Gangrenosum Surgery
          Rare Diseases Surgery
          Amnion Transplantation
          Chorion Transplantation
          Outcomes (Health Care)
          Female
          Aged
          Middle Age
          Human
          Retrospective Design
          Pilot Studies
          Descriptive Statistics
          Data Analysis Software
          Case Studies
          Pyoderma Gangrenosum Diagnosis
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
      ab: Objective: Pyoderma gangrenosum (PG) is an often-misdiagnosed, painful, inflammatory and ulcerative skin disorder. It is an orphan disease, where standard wound treatments such as sharp surgical debridement are contraindicated. This retrospective case series sought to evaluate the application of dehydrated human amnion/chorion membrane (DHACM) as a skin substitute in cases that were refractory to a range of standard-of-care techniques. Method: This retrospective case series involved wounds which failed to close with standard escalating treatments, including anti-inflammatory and immunosuppressive therapies. Subjects were transitioned to DHACM and wound sizes were monitored until closure. Results: Wounds (n=5) for all three subjects had stalled with standard therapies for at least 2.5 months but responded quickly to routinely applied DHACM treatments, and closure was achieved in each case. Conclusion: This retrospective pilot case series examined the use of DHACM as an alternative wound treatment for PG patients failing standard therapies. DHACM treatments re-initiated the trajectory towards wound closure for each stalled PG ulcer. The results suggest a treatment algorithm starting with early recognition, wound closure via treatment escalation, and lastly a gradual reduction in treatment for durable closure. DHACM treatment should be formally evaluated as an adjunct to PG ulcers that have remained refractory to more commonly used immunomodulating therapies.
      pubtype: Academic Journal
      doctype:
        case study
        pictorial
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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