Department of Dermatology, Oregon Health and Science University, Portland, Oregon, USA.
Department of Plastic Surgery, Weymouth, Massachusetts, USA.
Int Wound J. 2024 Nov;21(11):e70135. doi: 10.1111/iwj.70135.
Pyoderma gangrenosum (PG) is a rare, painful neutrophilic dermatosis characterized by rapidly progressing skin ulcers. Despite the importance of local wound care in managing PG, there is no consensus or evidence-based guidelines. This systematic review aimed to investigate local wound care strategies for PG. A comprehensive search of Embase, MEDLINE, and the Cochrane Library yielded 1213 references, from which 269 studies were included, covering 351 patients. The most reported treatment methods included sharp debridement (11%), topical corticosteroids (27%) and non-adherent dressings (12%). However, no clear correlation between these treatments and healing outcomes was found likely due to confounding factors such as varied wound sizes, superinfection and inconsistent reporting. Additionally, directed wound care regimens have not been able to show statistical significance for healing outcomes. Our study describes the current local wound care landscape and underscores a critical gap in the current literature regarding standardized treatment protocols for PG.
坏疽性脓皮病（PG）是一种罕见的、疼痛的中性粒细胞皮肤病，其特征是迅速进展的皮肤溃疡。尽管局部伤口护理在 PG 的管理中很重要，但目前尚无共识或循证指南。本系统评价旨在调查 PG 的局部伤口护理策略。对 Embase、MEDLINE 和 Cochrane 图书馆进行全面检索，共获得 1213 条参考文献，其中纳入了 269 项研究，涵盖了 351 名患者。报道最多的治疗方法包括锐性清创术（11%）、局部皮质类固醇（27%）和非粘性敷料（12%）。然而，由于伤口大小、感染和报告不一致等混杂因素，这些治疗方法与愈合结果之间似乎没有明显的相关性。此外，针对性的伤口护理方案也未能显示出对愈合结果的统计学意义。本研究描述了目前的局部伤口护理现状，并强调了当前文献中关于 PG 标准化治疗方案的一个关键空白。
