Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA.
Wounds. 2020 Dec;32(12):E59-E61.
Pyoderma gangrenosum (PG) is a rare, ulcerative dermatosis that is part of a systemic auto-inflammatory process. The overall incidence of PG is 5.8 per 100 000 individuals and it is associated with an increased mortality rate compared with the general population. Due to the pathergy phenomenon-present in 20% to 30% of cases-traumatic events, such as debridement or surgery, are often avoided in these patients. This report is on the use of negative pressure wound therapy with instillation and dwell time (NPWTi-d) combined with a reticulated open cell foam dressing with through holes (ROCF-CC) to achieve debridement and granulation in a lower extremity PG wound.
A known patient with history of neuropathic arthritis, systemic lupus erythematosus, and cryoglobulinemic vasculitis presented with worsening of his lower extremity wound including new onset pain, odor, and purulent discharge. Negative pressure wound therapy with instillation and dwell time using a hypochlorous acid solution and a ROCF-CC was initiated. Significant decrease in necrotic tissue was noted by day 4, with improved granulation tissue growth by day 25. No pathergy occurred in this case.
The use of NPWTi-d with ROCF-CC demonstrated positive debridement effects on this PG wound.
坏疽性脓皮病（PG）是一种罕见的溃疡性皮肤病，属于全身性自身炎症过程的一部分。PG 的总发病率为每 10 万人中有 5.8 人，与普通人群相比，其死亡率更高。由于存在 20%至 30%病例的化脓现象，这些患者通常避免进行创伤性事件，如清创或手术。本报告介绍了使用带有灌输和驻留时间（NPWTi-d）的负压伤口治疗和带有通孔的网状开放式细胞泡沫敷料（ROCF-CC），以实现下肢 PG 伤口的清创和肉芽形成。
一名已知患有神经关节炎、系统性红斑狼疮和冷球蛋白血症性血管炎的患者，下肢伤口恶化，出现新的疼痛、臭味和脓性分泌物。开始使用次氯酸溶液和 ROCF-CC 进行 NPWTi-d。第 4 天，坏死组织明显减少，第 25 天，肉芽组织生长情况改善。在这种情况下，没有化脓现象。
NPWTi-d 联合 ROCF-CC 的使用对这种 PG 伤口显示出积极的清创效果。
