Assessing the role of wound debridement in pyoderma gangrenosum—A retrospective cohort study.
The role of wound debridement in pyoderma gangrenosum (PG) is controversial, largely due to concerns regarding pathergy. This study sought to evaluate the clinical outcomes and utility of wound debridement in PG management. We conducted a retrospective cohort study of 104 patients diagnosed with PG...
| Publicado en: | Wound Repair & Regeneration Vol. 32; no. 6; pp. 941 - 949 |
|---|---|
| Autores principales: | , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Wiley-Blackwell
Nov2024
|
| 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=181057815&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 181057815 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10671927 DPV jtl: Wound Repair & Regeneration issn: 10671927 maglogo: Y pubinfo: dt: Nov2024 vid: 32 iid: 6 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 181057815 179588886 181057815 181057815 10.1111/wrr.13219 181057815 ppf: 941 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: C – @attributes: type: P tig: atl: Assessing the role of wound debridement in pyoderma gangrenosum—A retrospective cohort study. aug: au: Bar, Danielle Beberashvili, Ilia affil: Department of Dermatology, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel sug: subj: Pyoderma Gangrenosum Surgery Wound Care Methods Surgical Debridement Evaluation Treatment Outcomes Evaluation Human Female Male Adult Middle Age Aged Retrospective Design Prospective Studies Tertiary Health Care Immunosuppression Disease Remission Control Group Multivariate Analysis Confidence Intervals Disease Progression Comparative Studies Data Analysis Software T-Tests Mann-Whitney U Test Log-Rank Test Chi Square Test Fisher's Exact Test Cox Proportional Hazards Model Descriptive Statistics Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Female Male ab: The role of wound debridement in pyoderma gangrenosum (PG) is controversial, largely due to concerns regarding pathergy. This study sought to evaluate the clinical outcomes and utility of wound debridement in PG management. We conducted a retrospective cohort study of 104 patients diagnosed with PG at a single tertiary referral centre, stratified into two treatment groups: those receiving debridement in conjunction with immunosuppressive therapy (n = 38) and those treated with immunosuppression alone (control group, n = 66). The primary outcomes measured were remission (absence of active PG lesions without necessitating additional treatment), time to remission and disease progression (new lesions or expansion of existing ones). Remission was achieved by 60.53% (n = 23) in the debridement group versus 87.88% (n = 58) in the control group (p = 0.003). The mean time to remission was 12.3 months for the debridement group versus 8.67 months for the control group (p = 0.2). Multivariate Cox regression analysis indicated that debridement significantly decreased the likelihood of disease remission (adjusted hazards ratio [HR]: 0.45, 95% confidence interval [CI]: 0.26–0.78, p = 0.005). Disease progression was significantly higher in the debridement group (68.42%, n = 26) compared to the control group (15.15%, n = 10) (p < 0.001). Additionally, 28.95% (n = 11) of patients in the debridement group required repeated procedures, and 10.53% (n = 4) underwent amputations due to deteriorating conditions. The timing and duration of immunosuppressive therapy relative to the procedure did not mitigate the risk of post‐surgical exacerbations. These findings suggest that debridement is associated with poorer healing outcomes in PG, advocating for its contraindication in the management of this condition. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|