Gulyas Karoly, Kimble Frank W
Aesthetic Plast Surg. 2003 Jul-Aug;27(4):328-31. doi: 10.1007/s00266-003-3017-y.
Although rare, pyoderma gangrenosum (PG) occurs as one of the worst local complications following plastic surgery to the breast. The early manifestations are similar to a necrotizing wound infection, so diagnosis and correct management are often delayed. Failure of response to the aggressive treatment strategies needed for necrotizing wound infections and the phenomenon of pathergy will often raise the clinical suspicion of PG. The main steps of therapy consist of minimal wound debridement and initiation of corticosteroids and/or immune modulation. Repair of skin defects requires care and attention. Smaller defects are best left to heal by secondary intention, as pathergy can reactivate the syndrome and cause an even larger skin wound. Larger defects are repaired with skin grafts or flaps. We report a case of atypical (bullous) PG in a healthy 57 year-old white woman following reduction mammaplasty.
坏疽性脓皮病（PG）虽然罕见，但却是乳房整形手术后最严重的局部并发症之一。其早期表现与坏死性伤口感染相似，因此诊断和正确处理常常延迟。对坏死性伤口感染所需的积极治疗策略无反应以及同形反应现象常常会引起对PG的临床怀疑。治疗的主要步骤包括最小限度的伤口清创以及开始使用皮质类固醇和/或免疫调节。皮肤缺损的修复需要谨慎和关注。较小的缺损最好任其通过二期愈合，因为同形反应会使综合征重新激活并导致更大的皮肤伤口。较大的缺损则用皮肤移植或皮瓣修复。我们报告一例健康的57岁白人女性在乳房缩小整形术后发生非典型（大疱性）PG的病例。
