Lee Frank G, Song Ethan, Wallace Sean J, Shaughnessy Thomas J, Raj Mamtha, Teixeira Robert, Miles Marshall G, Wojcik Randolph
Division of Plastic and Reconstructive Surgery, University of South Florida Morsani College of Medicine, Tampa, USA.
Division of Plastic and Reconstructive Surgery, Lehigh Valley Health Network, Allentown, USA.
Cureus. 2021 Oct 21;13(10):e18951. doi: 10.7759/cureus.18951. eCollection 2021 Oct.
Pyoderma gangrenosum (PG) is a rare skin disorder primarily treated with immunosuppression medication. We report a case of a large, chronic PG wound treated with adjunct negative pressure wound therapy with instillation and dwell time (NPWTi-d) using nonadherent dressing (Mepitel) and reticular open-cell foam with through holes (ROCF-CC) with positive outcomes. The patient was a 62-year-old female with rheumatoid arthritis, Hashimoto's thyroiditis, lymphedema, and morbid obesity who presented with a 19.5 cm x 13.2 cm x 2.1 cm wound of three years duration on the right posterolateral lower extremity that successfully responded to a multimodality approach of immunosuppression and wound vac therapy. We conclude in our case that NPWTi-d with Mepitel and ROCF-CC enhanced the wound healing process, and we discuss NPWTi-d's potential role and benefit as an adjunctive therapy option for chronic and poorly controlled PG on patients taking concurrent immunosuppression.
坏疽性脓皮病（PG）是一种罕见的皮肤疾病，主要采用免疫抑制药物进行治疗。我们报告了一例大型慢性PG伤口，采用非粘性敷料（美皮贴）和带通孔的网状开孔泡沫敷料（ROCF-CC）进行负压伤口治疗（NPWTi-d）并取得了积极效果。患者为一名62岁女性，患有类风湿性关节炎、桥本甲状腺炎、淋巴水肿和病态肥胖，右下肢后外侧有一个19.5厘米×13.2厘米×2.1厘米、持续三年的伤口，通过免疫抑制和伤口负压治疗的多模式方法成功治愈。我们在该病例中得出结论，使用美皮贴和ROCF-CC的NPWTi-d促进了伤口愈合过程，并且我们讨论了NPWTi-d作为同时接受免疫抑制治疗的慢性且控制不佳的PG患者辅助治疗选择的潜在作用和益处。
