Aydın Serdar, Aydın Çağrı Arıoğlu, Uğurlucan Funda Güngör, Yaşa Cenk, Dural Özlem
Department of Obstetrics and Gynecology, Bezmialem Vakif University, Istanbul, Turkey; Department of Obstetrics and Gynecology, Istanbul University School of Medicine, Istanbul, Turkey.
J Obstet Gynaecol Res. 2015 Apr;41(4):635-9. doi: 10.1111/jog.12559. Epub 2014 Nov 5.
We describe the case of a 32-year-old woman (gravidity: 4; parity: 2) who underwent cesarean delivery at 37 weeks of gestation and presented with dehiscence and infection of the surgical wound. She had a history of wound infection and dehiscence of the scar from a previous cesarean delivery and dehiscence in the dorsal side of her left hand at the site of intravenous catheterization. The patient was initially diagnosed with a skin infection and later with pyoderma gangrenosum. No evidence of any underlying disease was found. The lesions were treated with systemic corticosteroids and azathioprine, but the lesions were unresponsive to treatment. This complicated case of pyoderma gangrenosum after cesarean delivery, which initially mimicked wound infection, was successfully treated with vacuum-assisted closure and split-thickness skin graft. This synergistic approach with vacuum-assisted closure could be an important treatment option for aggressive and slow-healing lesions.
我们描述了一名32岁女性（孕次：4；产次：2）的病例，她在妊娠37周时接受了剖宫产，术后出现手术伤口裂开和感染。她既往有过剖宫产术后伤口感染和瘢痕裂开史，以及左手背静脉置管部位的伤口裂开。患者最初被诊断为皮肤感染，后来诊断为坏疽性脓皮病。未发现任何潜在疾病的证据。病变采用全身用皮质类固醇和硫唑嘌呤治疗，但病变对治疗无反应。这种剖宫产术后坏疽性脓皮病的复杂病例，最初类似伤口感染，采用负压封闭引流术和中厚皮片移植成功治愈。这种负压封闭引流术的协同方法可能是治疗侵袭性和愈合缓慢病变的重要治疗选择。
